John Goligher Department of Colorectal Surgery, St James's University Hospital, Leeds, LS9 7TF, UK.
Br J Surg. 2014 Jan;101(1):e126-33. doi: 10.1002/bjs.9348. Epub 2013 Nov 28.
Laparoscopic surgery (LS) has become standard practice for a range of elective general surgical operations. Its role in emergency general surgery is gaining momentum. This study aimed to assess the outcomes of LS compared with open surgery (OS) for colorectal resections in the emergency setting.
A systematic review was performed of studies reporting outcomes of laparoscopic colorectal resections in the acute or emergency setting in patients aged over 18 years, between January 1966 and January 2013.
Twenty-two studies were included, providing outcomes for 5557 patients: 932 laparoscopic and 4625 open emergency resections. Median (range) operating time was 184 (63-444) min for LS versus 148 (61-231) min for OS. Median (range) length of stay was 10 (3-23) and 15 (6-33) days in the LS and OS groups respectively. The overall median (range) complication rate was 27.8 (0-33.3) and 48.3 (9-72) per cent respectively. There were insufficient data to detect differences in reoperation and readmission rates.
Emergency laparoscopic colorectal resection, where technically feasible, has better short-term outcomes than open resection.
腹腔镜手术（LS）已成为一系列择期普外科手术的标准治疗方法。它在急诊普外科中的作用也在不断增强。本研究旨在评估 LS 与 OS 治疗急症结直肠切除术的疗效。
对 1966 年 1 月至 2013 年 1 月期间，在年龄超过 18 岁的患者中，对 LS 治疗急症结直肠切除术的相关研究进行了系统回顾，报道了腹腔镜结直肠切除术结果的研究均被纳入。
共纳入 22 项研究，报道了 5557 例患者的结果：932 例 LS 和 4625 例 OS 紧急手术。LS 的中位（范围）手术时间为 184（63-444）min，OS 为 148（61-231）min。LS 和 OS 组的中位（范围）住院时间分别为 10（3-23）和 15（6-33）天。总的中位（范围）并发症发生率分别为 27.8（0-33.3）和 48.3（9-72）。再手术和再入院率的数据不足，无法检测到差异。
在技术可行的情况下，急诊 LS 结直肠切除术的短期疗效优于 OS。
