Tuech J J, Regenet N, Hennekinne S, Pessaux P, Bergamaschi R, Arnaud J P
Department of Digestive Surgery, Angers University Hospital, 4 rue Larrey, 49000 Angers, France.
Surg Endosc. 2001 Dec;15(12):1427-30. doi: 10.1007/s00464-001-9023-8.
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.
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.
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.
Data from the present study suggest that laparoscopic colectomy for sigmoid diverticulitis can be applied safely in overweight and obese patients
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。
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。
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。
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
