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单孔腹腔镜结肠切除术:早期经验。

Single-incision laparoscopic colectomy: early experience.

机构信息

Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong.

出版信息

Dis Colon Rectum. 2010 Mar;53(3):284-8. doi: 10.1007/DCR.0b013e3181c959ba.

Abstract

PURPOSE

Single-incision laparoscopic surgery was developed recently and has the benefit of reducing the number of incisions. Its application in colectomy has been published only in case reports. The present study evaluated our early results of single-incision laproscopic surgery in a series of 8 patients who underwent colectomy for various colorectal pathologies.

METHODS

Eight patients underwent single-incision laparoscopic colectomy for cancer (n = 5), polyps (n = 2), and diverticulitis (n = 1) during the study period. The data on the operations and outcomes were collected prospectively and analyzed.

RESULTS

The median age of the patients was 78 years (range, 49-88). The operations were right colectomy (n = 6), left colectomy (n = 1), and anterior resection (n = 1). The median operating time was 175 minutes (range, 103-260) and the median blood loss was 55 mL (range, 20-200). The average length of the incision was 3.4 cm (range, 3.0-5.0). One patient required conversion to hand-assisted laparoscopy with a 5-cm incision. The median hospital stay was 3.5 days (range, 3-6) and 1 patient had ileus after the operation. There was no mortality and no reintervention within 30 days. In patients with cancer, all of the resection margins were clear. The median number of lymph nodes examined was 13.5 (range, 9-36).

CONCLUSIONS

Single-incision laparoscopic surgery can be applied to colectomy safely. Oncologic resection similar to conventional laparoscopy can be performed with this technique. Further studies are needed to evaluate the outcomes against those of conventional laparoscopic resection.

摘要

目的

单切口腹腔镜手术是最近发展起来的,具有减少切口数量的优势。其在结肠切除术的应用仅见于病例报告。本研究评估了我们在 8 例因各种结直肠疾病而行结肠切除术的患者中应用单切口腹腔镜手术的早期结果。

方法

在研究期间,8 例患者因癌症(n=5)、息肉(n=2)和憩室炎(n=1)接受了单切口腹腔镜结肠切除术。前瞻性收集手术和结果数据并进行分析。

结果

患者的中位年龄为 78 岁(范围,49-88 岁)。手术包括右半结肠切除术(n=6)、左半结肠切除术(n=1)和前切除术(n=1)。中位手术时间为 175 分钟(范围,103-260 分钟),中位出血量为 55 毫升(范围,20-200 毫升)。切口平均长度为 3.4 厘米(范围,3.0-5.0 厘米)。1 例患者需要转为辅助腹腔镜手术,切口长 5.0 厘米。中位住院时间为 3.5 天(范围,3-6 天),1 例患者术后出现肠梗阻。无死亡病例,30 天内无再次干预。在癌症患者中,所有的切缘均无肿瘤残留。中位检查的淋巴结数为 13.5 个(范围,9-36 个)。

结论

单切口腹腔镜手术可安全应用于结肠切除术。该技术可进行与传统腹腔镜手术相似的肿瘤切除术。需要进一步的研究来评估该技术与传统腹腔镜切除术的结果。

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