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使用电热双极血管闭合装置的腹腔镜乙状结肠和直肠切除术

Laparoscopic sigmoid and rectal resection using an electrothermal bipolar vessel sealing device.

作者信息

Kössi Jyrki, Luostarinen Markku, Kontula Ilpo, Laato Matti

机构信息

Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland.

出版信息

J Laparoendosc Adv Surg Tech A. 2007 Dec;17(6):719-22. doi: 10.1089/lap.2006.0238.

Abstract

BACKGROUND

Laparoscopic colonic resection has gained popularity as a method to treat colonic diseases. The electrothermal bipolar vessel sealer (EBVS; LigaSure Atlas) is a modern device that allows the secure sealing of vessels with a diameter of up to 7 mm. The aim of the present study was to evaluate the suitability of the device for laparoscopic colonic surgery.

METHODS

The immediate outcome of 114 consecutive patients who underwent a sigmoid or rectal resection was prospectively analyzed. The intention was to perform all operations with the EBVS for dissection and ligation of the mesenterial vessels. Details on patient characteristics, peroperative and postoperative complications, and postoperative recovery were recorded prospectively and analyzed.

RESULTS

One hundred and fourteen patients were scheduled for elective left-sided colonic or rectal resection. Massive intra-abdominal adhesions in 1 patient required a conversion of the laparoscopic procedure to an open one; In total, 113 laparoscopic operations were thus performed. The mean operative time was 87.7 +/- 2.8 minutes, and the mean time for patients to tolerate solid food was 3.4 +/- 0.1 days and the time to discharge from hospital was 4.6 +/- 0.2 days. There were nine (8.0%) general complications, and additionally, 10.6% of patients suffered from surgical complications.

CONCLUSIONS

The electrothermal bipolar vessel sealer is suitable and safe for laparoscopic sigmoid and rectal resections. The use of the device probably reduces the operative time.

摘要

背景

腹腔镜结肠切除术作为治疗结肠疾病的一种方法已越来越受欢迎。电热双极血管闭合器(EBVS;LigaSure Atlas)是一种现代设备,可安全闭合直径达7毫米的血管。本研究的目的是评估该设备在腹腔镜结肠手术中的适用性。

方法

前瞻性分析114例连续接受乙状结肠或直肠切除术患者的即时结果。所有手术均打算使用EBVS进行肠系膜血管的解剖和结扎。前瞻性记录并分析患者特征、术中及术后并发症以及术后恢复的详细情况。

结果

114例患者计划进行择期左侧结肠或直肠切除术。1例患者因腹腔内大量粘连,需将腹腔镜手术改为开放手术;因此,共进行了113例腹腔镜手术。平均手术时间为87.7±2.8分钟,患者耐受固体食物的平均时间为3.4±0.1天,出院时间为4.6±0.2天。共有9例(8.0%)发生一般并发症,此外,10.6%的患者出现手术并发症。

结论

电热双极血管闭合器适用于腹腔镜乙状结肠和直肠切除术且安全。使用该设备可能会缩短手术时间。

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