Nam Young-Soo, Wexner Steven D
Department of Surgery, Hanyang University Kuri Hospital, Seoul, Korea.
J Korean Med Sci. 2002 Oct;17(5):633-5. doi: 10.3346/jkms.2002.17.5.633.
One of the hazards of colorectal surgery is ureteric injury. The aim of this study was to evaluate the results of ureteric catheterization regarding its safety and operative time. One-hundred sixty two patients underwent laparoscopic segmental left or right colectomy. The mean time for placement of ureteric catheters was 11.4 min for the right hemicolectomy and 11.3 min for the left hemicolectomy group. The mean preparation times for right hemicolectomy and left hemicolectomy (group 1 vs. group 2) were 54.7 vs. 39.1 min (p=0.00001) and 61.4 vs. 47.6 min (p=0.006), respectively. There were no significant differences in the laparoscopic operative time in either the right or left hemicolectomy groups (134.2 vs. 145.5 min and 198.4 vs. 170.1 min, respectively). There was no morbidity directly related to the ureteric catheters and in fact the incidence of postoperative urinary tract infection was lower in group 1 (1.5%) than in group 2 (5.3%) (p<0.05). Although the use of ureteric catheters added a mean of 11.3 min to the surgical procedure, the overall anesthetic time for right hemicolectomy was no longer than that for left hemicolectomy. The morbidity rate was quite acceptable. Thus, ureteric catheters may be useful in selected cases of laparoscopic left and right colorectal resections.
结直肠手术的风险之一是输尿管损伤。本研究的目的是评估输尿管插管在安全性和手术时间方面的效果。162例患者接受了腹腔镜下左半结肠或右半结肠切除术。右半结肠切除术放置输尿管导管的平均时间为11.4分钟,左半结肠切除术组为11.3分钟。右半结肠切除术和左半结肠切除术(第1组与第2组)的平均准备时间分别为54.7分钟对39.1分钟(p = 0.00001)和61.4分钟对47.6分钟(p = 0.006)。右半结肠切除术组和左半结肠切除术组的腹腔镜手术时间均无显著差异(分别为134.2分钟对145.5分钟和198.4分钟对170.1分钟)。没有与输尿管导管直接相关的发病率,实际上第1组术后尿路感染的发生率(1.5%)低于第2组(5.3%)(p<0.05)。虽然使用输尿管导管使手术过程平均增加了11.3分钟,但右半结肠切除术的总麻醉时间并不长于左半结肠切除术。发病率相当可接受。因此,输尿管导管在某些腹腔镜下左右结直肠切除术病例中可能有用。