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肥胖和非肥胖患者乙状结肠憩室炎的腹腔镜结肠切除术:一项前瞻性比较研究。

Laparoscopic colectomy for sigmoid diverticulitis in obese and nonobese patients: a prospective comparative study.

作者信息

Tuech J J, Regenet N, Hennekinne S, Pessaux P, Bergamaschi R, Arnaud J P

机构信息

Department of Digestive Surgery, Angers University Hospital, 4 rue Larrey, 49000 Angers, France.

出版信息

Surg Endosc. 2001 Dec;15(12):1427-30. doi: 10.1007/s00464-001-9023-8.

Abstract

BACKGROUND

The aim of this prospective comparative study was to assess the outcome of laparoscopic colectomy for sigmoid diverticulitis in normal-weight, overweight, and obese patients.

METHODS

From January 1995 to December 2000, all patients (n = 77) undergoing an elective colectomy for sigmoid diverticulitis were enrolled in the study. The patients were divided into three groups: Group 1 (n = 29) consisted of healthy, normal-weight patients (BMI, 18-24.9); group 2 (n = 27) consisted of overweight patients (BMI, 25.0-29.9); group 3 (n = 21) consisted of obese patients (BMI, 30.0-39.9). Groups 2 and 3 were compared with group 1.

RESULTS

Group 1 was comprised of 13 women and 16 men with a mean age of 58.4 years (range, 37-78); group 2, was comprised of 13 women and 14 men with a mean age of 55.2 years (range, 31-83); group 3, was comprised of 13 women and 14 men with a mean age of 54.1 years (range, 33-86). There was no difference among the three groups in ASA classification, postoperative length of hospital stay, or inpatient rehabilitation. The operating time did not differ for groups 1 and 2 (187 vs 210 min, p = 0.6), but it was shorter in group 1 than in group 3 (187 vs 247 min, p = 0.003). The conversion rate was similar for all three groups: 17.2% in group 1, 14.8% in group 2, and 19% in group 3. The postoperative period during which parenteral analgesics were required did not differ between groups 1 and 2 (5.7 vs 7.7 days, p = 0.1), but it was longer for group 3 (8.5 days, p = 0.03). The morbidity rate was similar for all three groups: 17.2% in group 7, 14.8% in group 2, and 19% in group 3. There were no perioperative deaths.

CONCLUSIONS

Data from the present study suggest that laparoscopic colectomy for sigmoid diverticulitis can be applied safely in overweight and obese patients

摘要

背景

这项前瞻性比较研究的目的是评估正常体重、超重和肥胖患者行乙状结肠憩室炎腹腔镜结肠切除术的结果。

方法

1995年1月至2000年12月,所有因乙状结肠憩室炎接受择期结肠切除术的患者(n = 77)均纳入本研究。患者分为三组:第1组(n = 29)由健康的正常体重患者组成(BMI,18 - 24.9);第2组(n = 27)由超重患者组成(BMI,25.0 - 29.9);第3组(n = 21)由肥胖患者组成(BMI,30.0 - 39.9)。将第2组和第3组与第1组进行比较。

结果

第1组由13名女性和16名男性组成,平均年龄58.4岁(范围,37 - 78岁);第2组由13名女性和14名男性组成,平均年龄55.2岁(范围,31 - 83岁);第3组由13名女性和14名男性组成,平均年龄54.1岁(范围,33 - 86岁)。三组在ASA分级、术后住院时间或住院康复方面无差异。第1组和第2组的手术时间无差异(187 vs 210分钟,p = 0.6),但第1组的手术时间比第3组短(187 vs 247分钟,p = 0.003)。三组的中转率相似:第1组为17.2%,第2组为14.8%,第3组为19%。第1组和第2组术后需要胃肠外镇痛的时间无差异(5.7 vs 7.7天,p = 0.1),但第3组更长(8.5天,p = 0.03)。三组的发病率相似:第1组为17.2%,第2组为14.8%,第3组为19%。围手术期无死亡病例。

结论

本研究数据表明,乙状结肠憩室炎腹腔镜结肠切除术可安全应用于超重和肥胖患者

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