Zmora Oded
Department of Surgery and Transplantation, Colon and Rectal Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Semin Laparosc Surg. 2003 Dec;10(4):159-67. doi: 10.1177/107155170301000402.
The laparoscopic approach to Crohn disease offers the multiple potential benefits of faster recovery, better cosmesis, and a lower incidence of adhesion-related complications and incisional hernias. Most of these advantages are unproven, but a review of the current literature reveals that advantages have been suggested in almost all series that have compared laparoscopy to laparotomy. Some features of Crohn disease, such as fistula, abscess, and phlegmon, may pose a surgical challenge; however, laparoscopic resection is often feasible, with morbidity rates comparable to or lower than those associated with laparotomy. Experience both in advanced laparoscopic techniques and surgery for Crohn disease, coupled with sound surgical judgment and a reasonably low threshold to convert to laparotomy before intraoperative complications occur, are essential for the successful and safe employment of these procedures.
腹腔镜治疗克罗恩病具有多种潜在益处，包括恢复更快、美容效果更好，以及粘连相关并发症和切口疝的发生率更低。其中大多数优势尚未得到证实，但对当前文献的回顾显示，几乎所有比较腹腔镜手术与开腹手术的系列研究都表明了其优势。克罗恩病的一些特征，如瘘管、脓肿和蜂窝织炎，可能带来手术挑战；然而，腹腔镜切除术通常是可行的，其发病率与开腹手术相当或更低。先进的腹腔镜技术经验以及克罗恩病手术经验，再加上合理的手术判断力和在术中并发症发生前转为开腹手术的合理低阈值，对于成功、安全地实施这些手术至关重要。
