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既往腹部手术对结直肠腹腔镜手术结果的影响:一项对比临床研究。

Impact of previous abdominal surgery on colorectal laparoscopy results: a comparative clinical study.

作者信息

Arteaga González Iván, Martín Malagón Antonio, López-Tomassetti Fernández Eudaldo M, Arranz Durán Javier, Díaz Luis Hermógenes, Carrillo Pallares Angel

机构信息

Department of Gastrointestinal Surgery, Hospital Universitario de Canarias (HUC), Canary Islands, Spain.

出版信息

Surg Laparosc Endosc Percutan Tech. 2006 Feb;16(1):8-11. doi: 10.1097/01.sle.0000202188.57537.07.

Abstract

To assess the results of laparoscopic colorectal surgery in patients who have previously undergone abdominal surgery. Between November 2002 and June 2004, 86 patients underwent laparoscopic surgery for colorectal disease at our hospital. Patients were divided into 2 groups depending on whether they had previously undergone abdominal surgery (previous surgery group, n = 27) or not (nonprevious surgery group, n = 59). Data were prospectively collected for statistical analyses of demographic, clinical, and histologic variables. Groups were comparable in age, body mass index, American Society of Anesthesiologists score, diagnosis, technique performed, and tumor size and distance to anal verge. There was no difference in perioperative complication rates. A higher conversion rate was found in the previous surgery group (26.1% vs. 5.1%, P = 0.02). In patients with tumor diseases, resection evaluations were no different regarding specimen length, distal and radial resection margins, or number of lymph nodes harvested. Laparoscopic colorectal surgery has proved to be a reliable technique for patients who have previously undergone abdominal surgery, its results comparable to those obtained with patients who have not.

摘要

评估既往接受过腹部手术的患者行腹腔镜结直肠手术的结果。2002年11月至2004年6月期间,我院86例患者因结直肠疾病接受了腹腔镜手术。根据患者既往是否接受过腹部手术,将患者分为两组(既往手术组,n = 27;未接受过手术组,n = 59)。前瞻性收集数据,对人口统计学、临床和组织学变量进行统计分析。两组在年龄、体重指数、美国麻醉医师协会评分、诊断、手术技术、肿瘤大小及距肛缘距离方面具有可比性。围手术期并发症发生率无差异。既往手术组的中转率更高(26.1%对5.1%,P = 0.02)。对于肿瘤性疾病患者,在标本长度、远侧切缘和径向切缘或所获淋巴结数量方面,切除评估无差异。对于既往接受过腹部手术的患者,腹腔镜结直肠手术已被证明是一种可靠的技术,其结果与未接受过腹部手术的患者相当。

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