Bezsilla János, Bende Sándor, Varga Lajos, Botos Akos, Liptay-Wagner Péter, Sikorszki László, Sümegi János, Nagy György
Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház, Altalános Sebészeti Osztály.
Magy Seb. 2005 Oct;58(5):305-10.
The use of laparoscopy in colorectal surgery is expanding. Minimally invasive surgery of benign lesions is widely accepted and can be performed with good results even during the learning curve. After gaining adequate expertise one can remove polyps which can not be treated with a colonoscope and early colonic carcinomas. We performed 16 laparoscopic resections for colon polyps and early carcinomas between December 2002 and March 2005. On one occasion a benign polyp was removed through mini laparotomy after colotomy; 13 resections and 2 subtotal colectomies were performed. One conversion due to intraoperative bleeding and one reoperation for anastomotic leak was necessary. One patient died after late postoperative mesenteric artery occlusion but if there was no complication definite advantages of the minimally invasive technique were observed. The laparoscopic approach can safely be used in selected patients. After training in the standard surgical procedure one can proceed to more radical surgery in adequately controlled studies.
腹腔镜在结直肠手术中的应用正在不断拓展。良性病变的微创手术已被广泛接受，即使在学习曲线阶段也能取得良好效果。在积累了足够的专业技能后，就可以切除结肠镜无法处理的息肉以及早期结肠癌。2002年12月至2005年3月期间，我们进行了16例腹腔镜下结肠息肉和早期癌切除术。有1次在结肠切开术后通过迷你剖腹术切除了1个良性息肉；进行了13例切除术和2例次全结肠切除术。因术中出血而中转1例，因吻合口漏而再次手术1例。1例患者术后晚期发生肠系膜动脉闭塞死亡，但如果没有并发症，微创技术的明确优势是显而易见的。腹腔镜手术方法可安全地应用于选定的患者。在掌握了标准手术操作后，在适当控制的研究中可以进行更根治性的手术。
