急诊腹腔镜结肠切除术：它能与开腹手术相媲美吗？
Emergency laparoscopic colectomy: does it measure up to open?
作者信息
Stulberg Jonah J, Champagne Brad J, Fan Zhen, Horan Mike, Obias Vincent, Marderstein Eric, Reynolds Harry, Delaney Conor P
机构信息
Department of Surgery, Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106-5047, USA.
出版信息
Am J Surg. 2009 Mar;197(3):296-301. doi: 10.1016/j.amjsurg.2008.09.010.
BACKGROUND
Laparoscopic colectomy has become the standard of care for elective resections; however, there are few data regarding laparoscopy in the emergency setting.
METHODS
By using a database with prospectively collected data, we identified 94 patients who underwent an emergency colectomy between August 2005 and July 2008. Laparoscopic surgeries were performed in 42 patients and were compared with 25 patients who were suitable for laparoscopy but received open colectomy.
RESULTS
The groups had similar demographics with no differences in age, sex, or surgical indications. Blood loss was lower (118 vs 205 mL; P < 0.01) and the postoperative stay was shorter (8 vs 11 d; P = 0.02) in the laparoscopic patients, and perioperative mortality rates were similar between the 2 groups (1 vs 3; P = 0.29).
CONCLUSIONS
With increasing experience, laparoscopic colectomy is a feasible option in certain emergency situations and is associated with shorter hospital stay, less morbidity, and similar mortality to that of open surgery.
背景
腹腔镜结肠切除术已成为择期切除的标准治疗方法；然而，关于急诊情况下腹腔镜手术的数据较少。
方法
通过使用一个前瞻性收集数据的数据库，我们确定了94例在2005年8月至2008年7月期间接受急诊结肠切除术的患者。42例患者接受了腹腔镜手术，并与25例适合腹腔镜手术但接受开腹结肠切除术的患者进行了比较。
结果
两组患者的人口统计学特征相似，在年龄、性别或手术指征方面无差异。腹腔镜手术患者的失血量较少（118对205毫升；P<0.01），术后住院时间较短（8对11天；P=0.02），两组围手术期死亡率相似（1对3；P=0.29）。
结论
随着经验的增加，腹腔镜结肠切除术在某些急诊情况下是一种可行的选择，并且与较短的住院时间、较低的发病率以及与开腹手术相似的死亡率相关。
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