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急性腹腔镜手术治疗憩室病(AIDD):一种可行的方法。

Acute laparoscopic intervention for diverticular disease (AIDD): a feasible approach.

机构信息

Division of General, Visceral and Transplant Surgery, University Hospital Tuebingen, Hoppe-Seyler-Str. 3, 72076, Tuebingen, Germany.

出版信息

Langenbecks Arch Surg. 2010 Jan;395(1):41-8. doi: 10.1007/s00423-008-0433-0. Epub 2008 Nov 11.

Abstract

INTRODUCTION

Early laparoscopic rectosigmoid resection for acute complicated diverticulitis may avoid secondary hospital stay and stoma-related complications. Benefits of elective surgical therapies could advance the early laparoscopic approach for acute sigmoid diverticulitis.

MATERIAL AND METHODS

From January 2006 to April 2007, a total of 26 patients underwent laparoscopic rectosigmoid resection for acute complicated diverticulitis. Laparoscopy was performed after initial antibiotic treatment and within 10 days after admission to the hospital. Characteristics and outcome were recorded prospectively.

RESULTS

Mean age for 13 females was 63.3 years (range, 45-78 years) and for 13 males was 56.2 years (range, 37-76 years). A body mass index of >or=25.0 kg/m(2) was registered in 20/26 patients. Mean operative time was 122.1 min (range, 60-192 min) and mean length of the sigmoid specimen was 179 mm (range, 120-240 mm). Mean time of recovery after surgery was 7.9 days (range, 6-12 days). Operative-related complications were two wound seromas. No anastomotic leak was observed. One month postoperatively, a condition-specific quality of life questionnaire assessed significant increase of the general score index, emotional status, and medical treatment.

CONCLUSION

This prospective study demonstrates the feasibility of an early laparoscopic rectosigmoid resection for acute complicated diverticulitis with an excellent outcome and a low morbidity rate.

摘要

介绍

早期腹腔镜直肠乙状结肠切除术治疗急性复杂憩室炎可避免二次住院和造口相关并发症。择期手术治疗的益处可能会促进急性乙状结肠憩室炎的早期腹腔镜治疗。

材料和方法

2006 年 1 月至 2007 年 4 月,共有 26 例患者因急性复杂憩室炎行腹腔镜直肠乙状结肠切除术。在初始抗生素治疗后和入院后 10 天内进行腹腔镜检查。前瞻性记录特征和结果。

结果

13 名女性的平均年龄为 63.3 岁(范围 45-78 岁),13 名男性的平均年龄为 56.2 岁(范围 37-76 岁)。26 例患者中有 20 例体质量指数(BMI)≥25.0 kg/m2。手术时间平均为 122.1 分钟(范围 60-192 分钟),乙状结肠标本长度平均为 179mm(范围 120-240mm)。术后恢复时间平均为 7.9 天(范围 6-12 天)。手术相关并发症为 2 例切口血清肿。未观察到吻合口漏。术后 1 个月,使用特定疾病的生活质量问卷评估,总评分指数、情绪状态和医疗均显著增加。

结论

这项前瞻性研究证明了早期腹腔镜直肠乙状结肠切除术治疗急性复杂憩室炎的可行性,其结果良好,发病率低。

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