腹腔镜全结肠切除术：适应证是否影响手术结果？
Laparoscopic total colectomy: Does the indication influence the outcome?
机构信息
Eddy Cotte, Yves François, Olivier Glehen, Department of Digestive Surgery, Centre Hospitalo-Universitaire Lyon Sud, Hospices Civils de Lyon, 69495 Pierre Bénite Cedex, France.
出版信息
World J Gastrointest Surg. 2011 Nov 27;3(11):177-82. doi: 10.4240/wjgs.v3.i11.177.
AIM
To assess and compare outcomes of laparoscopic total colectomy performed for a variety of indications.
METHODS
Sixty six patients underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre- and post-operative outcomes were collected prospectively.
RESULTS
Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a significantly higher anastomotic leak rate (23.1% vs 1.9%, P < 0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P < 0.05). No significant difference was found in return of gut function and overall morbidity between disease groups.
CONCLUSION
Laparoscopic total colectomy is feasible and outcomes are equivalent whatever the indication, except for anastomotic leak rate which is higher for patients with IBD.
目的
评估和比较腹腔镜全结肠切除术治疗多种适应证的结果。
方法
66 例患者因炎症性肠病（IBD）（13 例）和其他疾病（53 例）接受腹腔镜全结肠切除术。前瞻性收集人口统计学和围手术期结局数据。
结果
平均手术时间为 4.5 小时。转换率为 13.6%。IBD 患者的全结肠切除术吻合口漏发生率显著更高（23.1%比 1.9%，P<0.05）。单因素分析显示，手工吻合和至少使用 20mg 泼尼松龙治疗 3 个月以上与更高的吻合口漏发生率相关（P<0.05）。不同疾病组之间肠道功能恢复和总体发病率无显著差异。
结论
腹腔镜全结肠切除术是可行的，结果与适应证无关，除了 IBD 患者的吻合口漏发生率更高。
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