Leblanc F, Champagne B J, Augestad K M, Stein S L, Marderstein E, Reynolds H L, Delaney C P
Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5047, USA.
Diagn Ther Endosc. 2010;2010:913216. doi: 10.1155/2010/913216. Epub 2010 May 30.
Background. This paper studied technical aspects and feasibility of single incision laparoscopic colectomy (SILC). Methods. Bibliographic search was carried out up to October 2009 including original articles, case reports, and technical notes. Assessed criteria were techniques, operative time, scar length, conversion, complications, and hospitalization duration. Results. The review analyzed seventeen SILCs by seven surgical teams. A single port system was used by four teams. No team used the same laparoscope. Two teams used two laparoscopes. All teams used curved instruments. SILC time was 116 +/- 34 minutes. Final scar was longer than port incision (31 +/- 7 versus 24 +/- 8 mm; P = .036). No conversion was reported. The only complication was a bacteremia. Hospitalization was 5 +/- 2 days. Conclusion. SILC is feasible. A single incision around the umbilical scar represents cosmetic progress. Comparative studies are needed to assess potential abdominal wall and recovery benefits to justify the increased cost of SILC.
背景。本文研究了单切口腹腔镜结肠切除术(SILC)的技术方面及可行性。方法。截至2009年10月进行了文献检索,包括原始文章、病例报告和技术笔记。评估标准为技术、手术时间、疤痕长度、中转情况、并发症及住院时间。结果。该综述分析了七个手术团队的17例单切口腹腔镜结肠切除术。四个团队使用了单孔系统。没有团队使用相同的腹腔镜。两个团队使用了两个腹腔镜。所有团队均使用了弯形器械。单切口腹腔镜结肠切除术时间为116±34分钟。最终疤痕比切口长(31±7对24±8毫米;P = 0.036)。未报告中转情况。唯一的并发症是菌血症。住院时间为5±2天。结论。单切口腹腔镜结肠切除术是可行的。脐部疤痕周围的单一切口代表了美容方面的进步。需要进行比较研究以评估潜在的腹壁和恢复益处,从而证明单切口腹腔镜结肠切除术增加的成本是合理的。