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首页> 外文期刊>Surgical Endoscopy >Initial repair of iatrogenic colon perforation using laparoscopic methods.
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Initial repair of iatrogenic colon perforation using laparoscopic methods.

机译：使用腹腔镜方法初步修复医源性结肠穿孔。

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BACKGROUND: Iatrogenic perforation of the colon during elective colonoscopy is a rare but serious complication. Treatment using laparoscopic methods is a novel approach, only described in the recent literature. We hypothesized that laparoscopic treatment of iatrogenic colon perforation would result in equal therapeutic efficacy, less perioperative morbidity, smaller incisions and decreased length of stay, and an overall better short-term outcome compared to open methods. METHODS: We reviewed our prospectively collected patient database from July 2001 to July 2005 and compared the intraoperative data and postoperative outcomes of patients who underwent laparoscopic primary repair versus those who had open primary repairs of iatrogenically perforated large bowel. RESULTS: The laparoscopic (mean age 70 years; range 20-91 years; 18 percent male) and open (mean age 68 years; range 36-87 years; 43 percent male) groups were similar with regard to age. Overall, patients who underwent laparoscopic (n = 11) versus open (n = 7) repair had comparable operative (OR) times (mean 104 minutes, range 60-150 minutes versus mean 98 minutes, range 40-130 minutes, p = 0.04), shorter length of stay [LOS, (5.1 +/- 1.7 days versus 9.2 +/- 3.1 days, p = 0.01)], fewer complications (two versus five, p = 0.02) and shorter incision length (16 +/- 14.7 mm versus 163 +/- 54.4 mm, p = 0.001). CONCLUSIONS: A laparoscopic approach to iatrogenic colon perforation results in decreased morbidity, decreased length of stay, and a shorter incision length compared to an open method. In those cases where it is feasible and the surgical skills exist, a laparoscopic attempt at colon repair should probably be the initial clinical approach.
机译：背景：选择性结肠镜检查期间结肠的医源性穿孔是一种罕见但严重的并发症。使用腹腔镜方法的治疗是一种新颖的方法，仅在最近的文献中有所描述。我们假设，与开放式方法相比，腹腔镜治疗医源性结肠穿孔将产生相同的治疗效果，更低的围手术期发病率，更小的切口和更短的住院时间，以及总体上更好的短期疗效。方法：我们回顾了我们从2001年7月至2005年7月收集的前瞻性患者数据库，并比较了接受腹腔镜初次修复与开放性初次行医源性穿孔大肠手术的患者的术中数据和术后结局。结果：腹腔镜组（平均年龄70岁;范围20-91岁;男性18％）和开放式（平均年龄68岁;范围36-87岁; 43％男性）在年龄方面相似。总体而言，接受腹腔镜（n = 11）对比开放（n = 7）修复的患者具有可比的手术（OR）时间（平均104分钟，范围60-150分钟，平均98分钟，范围40-130分钟，p = 0.04 ），更短的住院时间[LOS，（5.1 +/- 1.7天与9.2 +/- 3.1天，p = 0.01）]，并发症更少（2对5，p = 0.02）和较短的切口长度（16 +/-） 14.7毫米对比163 +/- 54.4毫米，p = 0.001）。结论：与开放式方法相比，腹腔镜治疗医源性结肠穿孔可降低发病率，缩短住院时间并缩短切口长度。在可行且有手术技能的情况下，腹腔镜结肠修补术可能是最初的临床方法。

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