腹腔镜辅助与开腹结肠切除术治疗炎症性肠病（IBD）患者的重症急性结肠炎：42例患者的回顾性研究
Laparoscopic-assisted vs open colectomy for severe acute colitis in patients with inflammatory bowel disease (IBD): a retrospective study in 42 patients.
作者信息
Dunker M S, Bemelman W A, Slors J F, van Hogezand R A, Ringers J, Gouma D J
机构信息
Department of Surgery, Academic Medical Center, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands.
出版信息
Surg Endosc. 2000 Oct;14(10):911-4. doi: 10.1007/s004640000262.
BACKGROUND
Inflammatory bowel disease (IBD) can be complicated by severe acute colitis. Emergency colectomy is mandatory if patients do not respond to intensive medical therapy. A minimally invasive approach such as laparoscopic-assisted colectomy might be beneficial in these patients. Therefore, we set out to assess the feasibility and the safety of emergency laparoscopic-assisted colectomy in IBD patients with severe acute colitis.
METHODS
A total of 42 consecutive patients underwent an emergency colectomy with end-ileostomy. Ten patients had laparoscopic-assisted colectomy, and 32 had open colectomy. Pre- and perioperative parameters, morbidity, and mortality were analyzed.
RESULTS
The two groups were comparable for patient characteristics. There were no conversions in the laparoscopic group. The operation time was longer in the laparoscopic group than in the open group (271 vs 150 min; p < 0.001), but the hospital stay was shorter (14.6 vs 18.0 days; p = 0.05). Complications were similar for the two groups.
CONCLUSION
Laparoscopic-assisted colectomy in IBD patients with severe acute colitis is feasible and as safe as open colectomy.
背景
炎症性肠病（IBD）可并发严重急性结肠炎。若患者对强化药物治疗无反应，则必须进行急诊结肠切除术。对于这些患者，诸如腹腔镜辅助结肠切除术之类的微创方法可能有益。因此，我们着手评估急诊腹腔镜辅助结肠切除术在患有严重急性结肠炎的IBD患者中的可行性和安全性。
方法
共有42例连续患者接受了急诊结肠切除术并进行了回肠造口术。10例患者接受了腹腔镜辅助结肠切除术，32例接受了开放结肠切除术。对术前和围手术期参数、发病率和死亡率进行了分析。
结果
两组患者的特征具有可比性。腹腔镜组无中转开腹情况。腹腔镜组的手术时间比开放组更长（271分钟对150分钟；p<0.001），但住院时间更短（14.6天对18.0天；p = 0.05）。两组的并发症相似。
结论
在患有严重急性结肠炎的IBD患者中，腹腔镜辅助结肠切除术是可行的，且与开放结肠切除术一样安全。
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