IRCAD/EITS, Department of General, Digestive and Endocrine Surgery University Hospital of Strasbourg, Strasbourg, France.
Colorectal Dis. 2013 Jan;15(1):109-14. doi: 10.1111/j.1463-1318.2012.03118.x.
The aim of this study is to demonstrate the efficacy of wireless capsule endoscopy for preoperative identification of bleeding sources and/or small bowel tumours in surgical patients and to evaluate the feasibility of single-port surgery in the treatment of such pathologies.
Five patients presenting with obscure gastrointestinal bleeding or/and mild small bowel obstruction were investigated to diagnose and localize the bleeding source or tumour using capsule endoscopy imaging, and, if necessary, with other investigative modalities. All patients were operated on using single-port surgery for small bowel exploration, lesion confirmation, small bowel resection and anastomosis.
Small bowel pathology was successfully detected by video capsule endoscopy in three of four patients, and was further substantiated by contrast CT, double-balloon endoscopy or enteroclysis. Complete small bowel exploration, intra-operative identification and oncological resection of the involved segment and anastomosis (intracorporeal and extracorporeal) was successfully performed in all five patients using single-port access without any complication, morbidity or mortality.
This study demonstrates the feasibility and safety of single-port small bowel resection performed after a high-quality preoperative localization of the tumour.
本研究旨在展示无线胶囊内镜在手术患者中术前识别出血源和/或小肠肿瘤的疗效，并评估单端口手术治疗此类病变的可行性。
对 5 名出现不明原因胃肠道出血和/或轻度小肠梗阻的患者进行检查，使用胶囊内镜成像诊断和定位出血源或肿瘤，如果必要，还可以使用其他检查方式。所有患者均采用单端口手术进行小肠探查、病变确认、小肠切除和吻合。
视频胶囊内镜成功检测到 4 例患者中的 3 例小肠病变，并通过对比 CT、双气囊内镜或肠灌洗进一步证实。5 例患者均成功完成了单端口入路的全小肠探查、术中确认和受累节段的肿瘤切除和吻合（体内和体外），无任何并发症、发病率或死亡率。
本研究证明了在高质量术前定位肿瘤的基础上，进行单端口小肠切除术的可行性和安全性。
