Donati Marcello, Memming Martin, Donati Angelo, Calò Pietro Giorgio, Nicolosi Angelo
UO di Chirurgia Generale I, Cattedra di Chirurgia Generale I, Policlinico Universitario di Catania.
Chir Ital. 2008 Jan-Feb;60(1):63-73.
The aim of the study was to evaluate the role of laparoscopic surgery in diverticular disease of the colon, in the experience of a specialized centre. Sixty-seven patients were observed from November 2004 to March 2006 at the Robert Koch Krankenhaus of Gehrden (Hannover) with a diagnosis of acute diverticulitis, chronic diverticulitis and/or complications and submitted to elective or emergency surgery. The mean operating time was 171.5 minutes for the laparoscopic approach, and 142.7 minutes for open surgery. Return to normal bowel function occurred after 3.7 days for laparoscopy, as against 4.4 days for open surgery. Mean hospital stay was 9.8 days for the laparoscopic approach and 16.3 days for open surgery. Morbidity was 18.6% (8 cases) in the laparoscopic group and 25% (6 cases) in the open group. Mortality was 0%. Re-operation was necessary in 5 cases in the laparoscopic group (11.6%) and in 4 cases (16.6%) in the open group. Laparoscopy is an important innovation in the surgical treatment of diverticular disease. This approach should be assessed in relation to patient characteristics, medical history and clinical presentation. The advantages of laparoscopy are shorter postoperative hospital stay, less postoperative pain, earlier discharge, better cosmetic result, less blood loss and less peritoneal contamination. In the advanced stages of disease open surgery still remains very important.
本研究的目的是在一个专业中心的经验基础上，评估腹腔镜手术在结肠憩室病治疗中的作用。2004年11月至2006年3月期间，在盖尔登（汉诺威）的罗伯特·科赫医院对67例诊断为急性憩室炎、慢性憩室炎和/或并发症并接受择期或急诊手术的患者进行了观察。腹腔镜手术的平均手术时间为171.5分钟，开放手术为142.7分钟。腹腔镜手术后3.7天恢复正常肠道功能，而开放手术为4.4天。腹腔镜手术的平均住院时间为9.8天，开放手术为16.3天。腹腔镜组的发病率为18.6%（8例），开放组为25%（6例）。死亡率为0%。腹腔镜组有5例（11.6%）需要再次手术，开放组有4例（16.6%）需要再次手术。腹腔镜检查是憩室病外科治疗中的一项重要创新。应根据患者特征、病史和临床表现对这种方法进行评估。腹腔镜检查的优点是术后住院时间短、术后疼痛轻、出院早、美容效果好、失血少和腹膜污染少。在疾病的晚期，开放手术仍然非常重要。
