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保留或不保留肠系膜下动脉的单通道腹腔镜左半结肠切除术:我们的初步经验。

Single access laparoscopic left hemicolectomy with or without inferior mesenteric artery preservation: our preliminary experience.

作者信息

Bracale U, Lazzara F, Merola G, Andreuccetti J, Barone M, Pignata G

机构信息

Department of General, Vascular and Thoracic Surgery, "Federico II" University, Naples, Italy -

出版信息

Minerva Chir. 2013 Jun;68(3):315-20.

Abstract

AIM

We report our preliminary experience in single access laparoscopic left hemicolectomy (SALLH) with or without inferior mesenteric artery preservation, showing the results of a selected group of patients.

METHODS

This retrospective case series enclosed all patients operated between October 2009 and June 2012 of a left hemicolectomy with single laparoscopic access for benign and malignant diseases. The mean follow-up was 18 months. Intraoperative and postoperative results were recorded.

RESULTS

This retrospective case series enclosed 24 patients. Mean operative time was 157.8 min. The mean final skin incision length was 3.65 cm. All operations were completed by a single access laparoscopic approach. There were no conversion or intraoperative mortality. There were no required any intraoperative blood transfusion. Only three cases of postoperative complication were registered. The mean flatus canalization was two days. The mean discharge time was seven days. At a mean 18-month follow-up there were no incisional hernia or deaths.

CONCLUSION

As best of our knowledge, we report one of the largest experience gained in Italy about SALLH. We think that although SALC could be safe and feasible, it cannot be considered as a "new standard" procedure used by anyone. In contrast we retain that it is mandatory that SALC continued to be evaluated into larger multicentric RCT.

摘要

目的

我们报告了在有或没有保留肠系膜下动脉的单通道腹腔镜左半结肠切除术(SALLH)方面的初步经验,展示了一组特定患者的治疗结果。

方法

该回顾性病例系列纳入了2009年10月至2012年6月间所有因良性和恶性疾病接受单通道腹腔镜左半结肠切除术的患者。平均随访时间为18个月。记录术中及术后结果。

结果

该回顾性病例系列纳入了24例患者。平均手术时间为157.8分钟。最终皮肤切口平均长度为3.65厘米。所有手术均通过单通道腹腔镜入路完成。无中转手术或术中死亡情况。术中无需输血。仅记录到3例术后并发症。平均排气时间为2天。平均出院时间为7天。平均随访18个月时,无切口疝或死亡病例。

结论

据我们所知,我们报告了意大利在SALLH方面获得的最大经验之一。我们认为,尽管SALLH可能是安全可行的,但不能将其视为任何人都可采用的“新标准”手术。相反,我们认为SALLH必须继续在更大规模的多中心随机对照试验中进行评估。

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