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首页> 外文期刊>Surgical Endoscopy >Alternative specimen extraction techniques after laparoscopic emergency colectomy in inflammatory bowel disease
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Alternative specimen extraction techniques after laparoscopic emergency colectomy in inflammatory bowel disease

机译：炎症性肠病腹腔镜紧急结肠切除术后的其他标本提取技术

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摘要

Background: Omitting the extraction site incision potentially further decreases the abdominal wall trauma in laparoscopic surgery. The purpose of this study was to report the results of alternative specimen extraction techniques after laparoscopic emergency colectomy in patients with inflammatory bowel disease (IBD). Methods: Ten consecutive patients with IBD underwent (sub)acute emergency colectomy for refractory disease from October 2009 until December 2010. The specimen was retrieved via the stoma site in three and transrectally in seven patients. Patient data were prospectively collected. In case of later completion proctectomy and pouch procedure, adhesions were systematically scored. Results: The extraction techniques were all feasible. Median operative time was 219 (interquartile range (IQR), 197-232) min. The pain scores and morphine requirement in patients decreased quickly after surgery. No infectious complications occurred. In five patients, a completion proctectomy was performed at a median time of 7 (IQR, 3.8-9.3) months after colectomy. All patients showed absence of any adhesions in the pelvis. In two patients, limited adhesions of the cut side of the mesentery were present. Conclusions: Specimen extraction via the rectum or stoma site is a safe, alternative way to extract the specimen after laparoscopic colectomy. No infectious complications were observed postoperatively and no pelvic adhesions were found during completion proctectomy.
机译：背景：省略腹腔镜手术可能会进一步减少提取部位的切口。这项研究的目的是报告炎症性肠病（IBD）患者腹腔镜紧急结肠切除术后替代标本提取技术的结果。方法：从2009年10月至2010年12月，对10例连续的IBD患者进行（亚）急性难治性急诊结肠切除术。通过造口部位取回标本的3例，经直肠取回的7例。前瞻性收集患者数据。如果以后完成直肠切除术和囊袋手术，则对粘连进行系统评分。结果：提取工艺均可行。中位手术时间为219分钟（四分位间距（IQR），197-232分钟）。术后患者的疼痛评分和吗啡需求量迅速下降。没有发生感染性并发症。在五名患者中，结肠切除术后的中位时间为7（IQR，3.8-9.3）个月，完成了直肠切除术。所有患者的骨盆均无粘连。在两名患者中，肠系膜切开侧的粘连有限。结论：通过直肠或造口部位提取标本是腹腔镜结肠切除术后提取标本的一种安全的替代方法。术后未观察到感染性并发症，在完成直肠切除术期间未发现骨盆粘连。

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