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单孔腹腔镜全结肠切除术

Single-incision laparoscopic total colectomy.

作者信息

Paranjape Charudutt, Ojo Oluwatosin J, Carne David, Guyton Daniel

机构信息

Department of Surgery, Akron General Medical Center, Akron, OH 44307, USA.

出版信息

JSLS. 2012 Jan-Mar;16(1):27-32. doi: 10.4293/108680812X13291597715826.

Abstract

BACKGROUND AND OBJECTIVES

To present our experience with a single-incision laparoscopic total colectomy, along with a literature review of all published cases on single-incision laparoscopic total colectomy.

METHODS

A total of 22 cases were published between 2010 and 2011, with our patient being case 23. These procedures were performed in the United States and United Kingdom. Surgical procedures included total colectomy with end ileostomy, proctocolectomy with ileorectal anastomosis, and total proctocolectomy with ileopouch-anal anastomosis. Intraoperative and postoperative data are analyzed.

RESULTS

Twenty-two of the 23 cases were performed for benign cases including Crohns, ulcerative colitis, and familial adenomatous polyposis. One case was performed for adenocarcinoma of the cecum. The mean age was 35.3 years (range, 13 to 64), the mean body mass index was 20.1 (range, 19 to 25), mean operative time was 175.9 minutes (range, 139 to 216), mean blood loss was 95.3mL (range, 59 to 200), mean incision length was 2.61cm (range, 2 to 3). Average follow-up was 4.6 months with 2 reported complications.

CONCLUSIONS

Single-incision laparoscopic total colectomy is feasible and safe in the hands of an experienced surgeon. It has been performed for both benign and malignant cases. It is comparable to the conventional multi-port laparoscopic total colectomy.

摘要

背景与目的

介绍我们单切口腹腔镜全结肠切除术的经验,并对已发表的所有单切口腹腔镜全结肠切除术病例进行文献综述。

方法

2010年至2011年共发表了22例病例,我们的患者为第23例。这些手术在美国和英国进行。手术方式包括全结肠切除末端回肠造口术、直肠结肠切除回肠直肠吻合术以及全直肠结肠切除回肠贮袋肛管吻合术。对术中及术后数据进行分析。

结果

23例病例中有22例为良性疾病,包括克罗恩病、溃疡性结肠炎和家族性腺瘤性息肉病。1例为盲肠癌。平均年龄为35.3岁(范围13至64岁),平均体重指数为20.1(范围19至25),平均手术时间为175.9分钟(范围139至216分钟),平均失血量为95.3mL(范围59至200mL),平均切口长度为2.61cm(范围2至3cm)。平均随访4.6个月,报告有2例并发症。

结论

在经验丰富的外科医生手中,单切口腹腔镜全结肠切除术是可行且安全的。该手术已用于良性和恶性病例。它与传统的多端口腹腔镜全结肠切除术相当。

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