Champagne Brad, Stulberg Jonah J, Fan Zhen, Delaney Conor P
Division of Colorectal Surgery, Institute for Surgery and Innovation, University Hospitals, Case Medical Center, 11100 Euclid Avenue, LKS 7, MS 5047, Cleveland, OH 44106-5047, USA.
Surg Endosc. 2009 Aug;23(8):1791-6. doi: 10.1007/s00464-008-0227-z. Epub 2008 Dec 6.
Laparoscopic colectomy (LC) is slowly becoming the standard of care for elective resections. However, the use of LC in the emergency setting is relatively unstudied. The authors describe their experience with a series of emergent and urgent LC cases for a variety of colorectal pathologies.
This study reviewed 20 consecutive patients who had a laparoscopic emergent or urgent colectomy over a 2-year period. Patient demographics, indications for surgery, operative details, and postoperative complications were examined.
Two cases were converted to open procedure, and the mean operative time was 162 min (median, 163 min). The average postoperative length of hospital stay was 8.1 days (median, 6 days). There was one reoperation and three readmissions within 30 days, with no mortality during the follow-up period. Six patients required intensive care unit (ICU) stays after surgery, and 40% of the patients had one or more postoperative complications.
With increasing experience, LC is a feasible option in nonelective situations. Further prospective and comparative studies will improve our understanding of the outcomes for emergency LC.
腹腔镜结肠切除术（LC）正逐渐成为择期切除的标准治疗方法。然而，在急诊情况下使用LC的相关研究相对较少。作者描述了他们处理一系列因各种结直肠病变而行急诊和紧急LC病例的经验。
本研究回顾了2年期间连续20例行腹腔镜急诊或紧急结肠切除术的患者。检查了患者的人口统计学资料、手术指征、手术细节和术后并发症。
2例中转开腹手术，平均手术时间为162分钟（中位数为163分钟）。术后平均住院时间为8.1天（中位数为6天）。30天内有1例再次手术和3例再次入院，随访期间无死亡病例。6例患者术后需要入住重症监护病房（ICU），40%的患者有1种或多种术后并发症。
随着经验的增加，LC在非择期情况下是一种可行的选择。进一步的前瞻性和对比研究将增进我们对急诊LC结局的理解。
