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肠内回肠结肠吻合术:综述。

Intracorporeal ileocolic anastomosis: a review.

机构信息

Division of Colon and Rectal Surgery, State University of New York, Stony Brook, HSC T18, Suite 046B, Stony Brook, NY, 11794-8191, USA.

出版信息

Tech Coloproctol. 2013 Oct;17(5):479-85. doi: 10.1007/s10151-013-0998-7. Epub 2013 Mar 22.

Abstract

This study is a narrative review of the current literature regarding intracorporeal ileocolic anastomosis in laparoscopic right colon resection for benign or malignant diseases of the right colon and terminal ileum. The search strategy included Medline, Embase, CINAHL, ACP Journal Club, and Cochrane databases with laparoscopic right colectomy and intracorporeal anastomosis as keywords. All retrieved references were screened by two independent blinded reviewers. Thirteen papers including 611 patients undergoing laparoscopic right colon resection with intracorporeal ileocolic anastomosis for benign or malignant diseases of the right colon and terminal ileum were identified. There were eight case series and five case control studies. Anastomoses were fashioned as antiperistaltic or isoperistaltic, totally stapled or stapled/handsewn. The mesenteric defect was mostly left open. Overall operating time ranged from 53 to 360 min. The most common specimen extraction site locations were periumbilical, suprapubic, or transvaginal with a median incision length ranging from 3 to 6 cm. The overall rate of surgical site infection was 2.7 %. The anastomotic leak rates varied from 0 to 8.5 %. Postoperative mortality was 0.12 %. Intracorporeal ileocolic anastomosis following laparoscopic resection of the right colon is not commonly performed, but offers potential benefits if carried out by experienced surgeons in selected patients.

摘要

这是一篇关于腹腔镜右半结肠切除术治疗右半结肠和末端回肠良恶性疾病中行肠腔内回肠结肠吻合术的文献综述。检索策略包括 Medline、Embase、CINAHL、ACP 期刊俱乐部和 Cochrane 数据库,检索词为腹腔镜右半结肠切除术和肠腔内吻合术。所有检索到的参考文献均由两位独立的盲法评审员进行筛选。共确定了 13 篇文献,包括 611 例因右半结肠和末端回肠良恶性疾病行腹腔镜右半结肠切除术并采用肠腔内回肠结肠吻合术的患者。其中 8 项为病例系列研究,5 项为病例对照研究。吻合方式为逆蠕动或同蠕动,全吻合器吻合或吻合器吻合加手工缝合。系膜缺损多为敞开式。总手术时间为 53 至 360 分钟。最常见的标本取出部位为脐周、耻骨上或经阴道,切口长度中位数为 3 至 6 厘米。总的手术部位感染率为 2.7%。吻合口漏的发生率为 0 至 8.5%。术后死亡率为 0.12%。如果由经验丰富的外科医生在选择的患者中进行,腹腔镜右半结肠切除术后行肠腔内回肠结肠吻合术并不常见,但具有潜在的益处。

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