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首页> 外文期刊>Surgical Endoscopy >Anastomosis level and specimen length in surgery for uncomplicated diverticulitis of the sigmoid.
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Anastomosis level and specimen length in surgery for uncomplicated diverticulitis of the sigmoid.

机译：单纯乙状结肠憩室炎的手术吻合水平和标本长度。

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BACKGROUND: Extent of bowel resection and level of anastomosis are unsettled issues of surgery for diverticulitis of the sigmoid. The aim of this study was to compare the adequacy of open colon resection (OCR) with that of laparoscopic colon resection (LCR) for uncomplicated diverticulitis of the sigmoid (UDS), specifically addressing level of anastomosis and length of specimen. METHODS: Comparisons were made between 40 selected patients undergoing LCR for UDS between 1992 and 1994 and 35 diagnosis-matched controls who previously underwent OCR by the same surgeons at the same institution. RESULTS: The OCR and LCR patients were well-matched for age, gender, weight, ASA grade, duration of symptoms, and number of previous admissions. There were no significant differences, respectively, between OCR and LCR patients in morbidity rates (2 vs. 5, p = 0.33) and rates of mobilization of the splenic flexure (17:18 vs. 29:11, p < 0.1). Specimen length (18 cm vs. 11 cm, p 0.01), colosigmoid vs. colorectal anastomosis (24:11 vs. 1:39, p 0.01), and presence of inflammatory cells at the proximal resection margin (2 vs. 11, p = 0.02) were significantly different. The OCR patients had statistically longer follow-up than LCR patients (63 months vs. 46 months, p 0.01). Recurrent diverticulitis rates were 9.6% and 2.7% after OCR and LCR, respectively (3 vs. 1, p = 0.73). CONCLUSIONS: Inadequate sigmoid resection should prompt diligence to take down the splenic flexure placing the distal anastomotic margin on the rectum to ensure adequate surgery.
机译：背景：肠切除的程度和吻合程度是乙状结肠憩室炎手术的未解决问题。这项研究的目的是比较开放性结肠切除术（OCR）与腹腔镜结肠切除术（LCR）对乙状结肠复杂性憩室炎（UDS）的适当性，特别是针对吻合水平和标本长度的问题。方法：比较1992年至1994年间接受过UDS的LCR的40例选择患者和35例先前由同一医师在同一机构接受过OCR的诊断匹配对照。结果：OCR和LCR患者在年龄，性别，体重，ASA等级，症状持续时间和既往入院次数方面非常匹配。 OCR和LCR患者的发病率（2比5，p = 0.33）和脾曲张动员率（17:18 vs. 29：11，p <0.1）分别无显着差异。标本长度（18 cm vs. 11 cm，p 0.01），结肠乙状结肠吻合术与结直肠吻合术（24:11 vs. 1:39，p 0.01），以及近端切除边缘的炎性细胞存在（2 vs 11，p = 0.02）显着不同。据统计，OCR患者的随访时间比LCR患者更长（63个月vs. 46个月，p 0.01）。 OCR和LCR后复发性憩室炎发生率分别为9.6％和2.7％（3比1，p = 0.73）。结论：乙状结肠切除术不足应促使患者勤奋切除脾弯曲，将远端吻合口边缘置于直肠上，以确保适当的手术。

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