Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware St. SE, MMC 450, Minneapolis, MN 55455, USA.
World J Surg. 2013 Mar;37(3):629-38. doi: 10.1007/s00268-012-1872-x.
A PubMed search of the biomedical literature was carried out to systematically review the role of laparoscopy in colonic diverticular disease. All original reports comparing elective laparoscopic, hand-assisted, and open colon resection for diverticular disease of the colon, as well as original reports evaluating outcomes after laparoscopic lavage for acute diverticulitis, were considered. Of the 21 articles chosen for final review, nine evaluated laparoscopic versus open elective resection, six compared hand-assisted colon resection versus conventional laparoscopic resection, and six considered laparoscopic lavage. Five were randomized controlled trials.
Elective laparoscopic colon resection for diverticular disease is associated with increased operative time, decreased postoperative pain, fewer postoperative complications, less paralytic ileus, and shorter hospital stay compared to open colectomy. Laparoscopic lavage and drainage appears to be a safe and effective therapy for selected patients with complicated diverticulitis.
Elective laparoscopic colectomy for diverticular disease is associated with decreased postoperative morbidity compared to open colectomy, leading to shorter hospital stay and fewer costs. Laparoscopic lavage has an increasing but poorly defined role in complicated diverticulitis.
对生物医学文献进行了 PubMed 检索，以系统地回顾腹腔镜在结肠憩室病中的作用。所有比较择期腹腔镜、手助腹腔镜和开腹结肠切除术治疗结肠憩室病的原始报告，以及评估腹腔镜灌洗治疗急性憩室炎后结果的原始报告，均被视为研究对象。在最终审查的 21 篇文章中，有 9 篇评估了腹腔镜与开腹择期切除术的比较，6 篇比较了手助结肠切除术与常规腹腔镜切除术，6 篇考虑了腹腔镜灌洗。其中 5 篇为随机对照试验。
与开腹结肠切除术相比，择期腹腔镜结肠切除术治疗憩室病可增加手术时间，减轻术后疼痛，减少术后并发症，减少麻痹性肠梗阻，缩短住院时间。对于某些复杂憩室炎患者，腹腔镜灌洗和引流似乎是一种安全有效的治疗方法。
与开腹结肠切除术相比，择期腹腔镜结肠切除术治疗憩室病可降低术后发病率，从而缩短住院时间和降低成本。腹腔镜灌洗在复杂憩室炎中的作用越来越重要，但定义不明确。
