Kiran Ravi P, Delaney Conor P, Senagore Anthony J, Millward Bruce L, Fazio Victor W
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Arch Surg. 2004 Jan;139(1):39-42. doi: 10.1001/archsurg.139.1.39.
Blood loss, measured by estimated blood loss, drop in hemoglobin levels, and transfusion requirements, is lower in patients undergoing laparoscopic colectomy compared with patients undergoing conventional open colectomy.
Case-matched study.
A university hospital.
Patients undergoing laparoscopic colectomy between January 2000 and December 2001 were matched in a prospective database for age, sex, comorbidity, and surgical procedure with patients undergoing open colectomy during the same period.
Estimated blood loss, drop in hemoglobin levels, and transfusion requirements after surgery were compared.
One hundred forty-seven patients undergoing the same operation using either an open or laparoscopic approach could be matched for age, sex, and diagnosis related grouping. There was no significant difference in American Society of Anesthesiologists class, body mass index, or preoperative and postoperative hemoglobin levels, but the open colectomy group required significantly more units of blood (P =.003) to maintain similar hemoglobin levels after surgery. Estimated blood loss (P<.001) and the number of patients who received transfusions on the day of surgery (P =.002), during the first 48 hours after surgery (P =.005), and during the entire hospital stay (P =.003) were significantly higher in the open colectomy group.
A laparoscopic approach for colorectal surgery led to significantly less blood loss than matched open colectomy cases.
通过估计失血量、血红蛋白水平下降以及输血需求来衡量，与接受传统开放性结肠切除术的患者相比，接受腹腔镜结肠切除术的患者失血量更少。
病例匹配研究。
一家大学医院。
2000年1月至2001年12月期间接受腹腔镜结肠切除术的患者在一个前瞻性数据库中与同期接受开放性结肠切除术的患者按年龄、性别、合并症和手术方式进行匹配。
比较术后估计失血量、血红蛋白水平下降情况以及输血需求。
147例采用开放或腹腔镜手术方式进行相同手术的患者在年龄、性别和诊断相关分组方面相匹配。美国麻醉医师协会分级、体重指数或术前及术后血红蛋白水平无显著差异，但开放性结肠切除术组为维持术后相似的血红蛋白水平需要显著更多单位的血液（P = 0.003）。开放性结肠切除术组的估计失血量（P<0.001）以及在手术当天（P = 0.002）、术后48小时内（P = 0.005）和整个住院期间（P = 0.003）接受输血的患者数量显著更高。
与匹配的开放性结肠切除术病例相比，腹腔镜结直肠手术方法导致的失血量显著减少。
