腹腔镜与开腹结肠切除术患者肠功能恢复情况及住院时间的比较。
Comparison of return of bowel function and length of stay in patients undergoing laparoscopic versus open colectomy.
作者信息
Salimath Jayaraj, Jones Mark W, Hunt Dan L, Lane Mindy K
机构信息
Ingham Regional Medical Center, Lansing, Michigan, USA.
出版信息
JSLS. 2007 Jan-Mar;11(1):72-5.
BACKGROUND
Over the last decade, many advances have been made in laparoscopic techniques in various surgical specialties. The technique of laparoscopic-assisted colectomy (LAC) has been reported since 1992 and has been slowly gaining popularity in the surgical community. Several studies have compared laparoscopic versus open colectomy, assessing its applicability to patients with colon cancer, Crohn's disease, and diverticular disease. Studies to date have assessed length of stay, operative time, and clinical outcome. This study focuses on return of bowel function and length of hospital stay in patients undergoing LAC compared with those undergoing open colectomy.
METHODS
We performed a retrospective review of patients undergoing either open colon resection or LAC between January 2000 and December 2005. All disease processes and both emergent and elective cases were included. Return of bowel function was determined by passage of flatus or first passage of stool and compared between the 2 groups. The data were statistically analyzed using the Student t test for interval data, and nominal data were analyzed using the chi-square analysis (95% confidence interval; CI).
RESULTS
The study included 247 patients; 179 (72.5%) underwent open colectomy and 68 (27.5%) underwent LAC. Passage of flatus took 3.6 days (95% CI .18 or 3.4 to 3.8) for open colectomy, and 2.9 days (95% CI .19 or 2.7 to 3.1) for LAC. First bowel movement took 4.4 days (95% CI .19 or 4.2 to 4.6) for open colectomy and 3.7 days (95% CI .22 or 3.5 to 3.9) for LAC. When compared between the groups, mean length of hospital stay was 8.01 days (95% CI .93 or 7.1 to 8.9) for open colectomy and 4.38 days (95% CI .38 or 4.0 to 4.8) for LAC.
CONCLUSION
Both return of bowel function and length of stay were statistically significantly shorter in LAC compared with those in open colectomy, which may indicate faster recovery after bowel surgery in patients undergoing the laparoscopic approach.
背景
在过去十年中，各种外科专业的腹腔镜技术都取得了许多进展。自1992年以来，腹腔镜辅助结肠切除术（LAC）技术已有报道，并在外科领域逐渐受到欢迎。多项研究比较了腹腔镜与开放结肠切除术，评估了其对结肠癌、克罗恩病和憩室病患者的适用性。迄今为止的研究评估了住院时间、手术时间和临床结果。本研究重点关注接受LAC的患者与接受开放结肠切除术的患者相比的肠功能恢复情况和住院时间。
方法
我们对2000年1月至2005年12月期间接受开放结肠切除术或LAC的患者进行了回顾性研究。纳入了所有疾病过程以及急诊和择期病例。通过排气或首次排便来确定肠功能恢复情况，并在两组之间进行比较。使用学生t检验对区间数据进行统计分析，使用卡方分析（95%置信区间；CI）对名义数据进行分析。
结果
该研究纳入了247例患者；179例（72.5%）接受了开放结肠切除术，68例（27.5%）接受了LAC。开放结肠切除术排气时间为3.6天（95%CI.18或3.4至3.8），LAC为2.9天（95%CI.19或2.7至3.1）。开放结肠切除术首次排便时间为4.4天（95%CI.19或4.2至4.6），LAC为3.7天（95%CI.22或3.5至3.9）。两组比较时，开放结肠切除术的平均住院时间为8.01天（95%CI.93或7.1至8.9），LAC为4.38天（95%CI.38或4.0至4.8）。
结论
与开放结肠切除术相比，LAC的肠功能恢复和住院时间在统计学上均显著缩短，这可能表明接受腹腔镜手术的患者肠道手术后恢复更快。
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