Frid Natalie Lassen, Bulut Orhan, Pachler Jørn
Gastroenheden, Kirurgisk Sektion, Hvidovre Hospital, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
Dan Med J. 2013 Jun;60(6):A4645.
Laparoscopic colectomy for both benign and malignant disease, including inflammatory bowel disease (IBD), has recently been shown to have many advantages compared with open surgery. This study aimed to compare the effect of laparoscopic versus open subtotal colectomy (STC) for IBD on overall morbidity.
A total of 99 patients undergoing STC for IBD at our institution from 2007 through 2011 were identified. Patients undergoing open STC were compared with patients undergoing laparoscopic STC. Outcomes included 30-day morbidity, conversion to laparotomy, intraoperative blood loss, operative time, admission time, late onset complications and 30-day mortality. Results are presented as median values.
A total of 57 patients underwent open STC (Group 1) and 42 patients laparoscopic STC (Group 2). Group 1 comprised 26 males and 31 females, with a median age of 35 years and a body mass index (BMI) of 23.2 kg/m2. Group 2 comprised 18 males and 24 females, with a median age of 34 years and a BMI of 23.5 kg/m2. Group 2 had less morbidity (42.9% versus 75.4%, p < 0.002), reduced blood loss (100 ml versus 200 ml, p < 0.001), longer operative time (193.5 min. versus 128 min., p < 0.001), shorter length of hospital stay (six days versus 16 days, p < 0.001) than Group 1. One patient died (Group 1). There was no difference in late onset complications and no conversions to laparotomy in the laparoscopic group.
Laparoscopic STC has a longer operative time, but improves short-term outcomes compared with open surgery.
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与开放手术相比,腹腔镜结肠切除术用于治疗包括炎症性肠病(IBD)在内的良性和恶性疾病,近来已显示出诸多优势。本研究旨在比较腹腔镜与开放次全结肠切除术(STC)治疗IBD对总体发病率的影响。
确定了2007年至2011年在我院接受IBD的STC手术的99例患者。将接受开放STC手术的患者与接受腹腔镜STC手术的患者进行比较。结果包括30天发病率、中转开腹、术中失血、手术时间、住院时间、迟发性并发症和30天死亡率。结果以中位数表示。
共有57例患者接受了开放STC手术(第1组),42例患者接受了腹腔镜STC手术(第2组)。第1组包括26例男性和31例女性,中位年龄35岁,体重指数(BMI)为23.2kg/m²。第2组包括18例男性和24例女性,中位年龄34岁,BMI为23.5kg/m²。第2组的发病率较低(42.9%对75.4%,p<0.002),失血量减少(100ml对200ml,p<0.001),手术时间更长(193.5分钟对128分钟,p<0.001),住院时间更短(6天对16天,p<0.001)。第1组有1例患者死亡。腹腔镜组迟发性并发症无差异,也无中转开腹情况。
腹腔镜STC手术时间较长,但与开放手术相比可改善短期预后。
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