Olson Craig H, Bedros Nicole, Hakiman Hekmat, Araghizadeh Farshid Y
Section of Colorectal Surgery, University of Texas Southwestern Medical Center, 1801 Inwood Rd, Ste WA4.416, Dallas, TX 75390-8819, USA.
Section of Colorectal Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
JSLS. 2014 Apr-Jun;18(2):258-64. doi: 10.4293/108680813X13753907292872.
Single-site laparoscopic colorectal surgery has been firmly established; however, few reports addressing this technique in the inflammatory bowel disease population exist.
We conducted a case-matched retrospective review of 20 patients who underwent single-site laparoscopic procedures for inflammatory bowel disease compared with 20 matched patients undergoing multiport laparoscopic procedures. Data regarding these patients were tabulated in the following categories: demographic characteristics, operative parameters, and perioperative outcomes.
A wide range of cases were completed: 9 ileocolic resections, 7 cases of proctocolectomy with end ileostomy or ileal pouch anal anastomosis, 2 cases of proctectomy with ileal pouch anal anastomosis, and 2 total abdominal colectomies with end ileostomy were all matched to equivalent multiport laparoscopic cases. No single-incision cases were converted to multiport laparoscopy, and 2 single-incision cases (10%) were converted to an open approach. For single-incision cases, the mean length of stay was 7.7 days, the mean time to oral intake was 3.3 days, and the mean period of intravenous analgesic use was 5.0 days. There were no statistically significant differences between single-site and multiport cases.
Single-site laparoscopic surgery is technically feasible in inflammatory bowel disease. The length of stay and period of intravenous analgesic use (in days) appear to be higher than those in comparable series examining outcomes of single-site laparoscopic colorectal surgery, and the outcomes are comparable with those of multiport laparoscopy. This may be because of the nature of inflammatory bowel disease, limiting the benefits of a single-site approach in this population.
单孔腹腔镜结直肠手术已得到广泛应用；然而，针对炎症性肠病患者采用该技术的报道较少。
我们对20例行单孔腹腔镜手术治疗炎症性肠病的患者与20例匹配的行多孔腹腔镜手术的患者进行了病例对照回顾性研究。将这些患者的数据按以下类别列表：人口统计学特征、手术参数和围手术期结果。
完成了多种病例：9例回结肠切除术、7例直肠结肠切除术加末端回肠造口术或回肠储袋肛管吻合术、2例直肠切除术加回肠储袋肛管吻合术以及2例全腹结肠切除术加末端回肠造口术，均与相应的多孔腹腔镜病例相匹配。没有单切口病例转为多孔腹腔镜手术，2例单切口病例（10%）转为开放手术。单切口病例的平均住院时间为7.7天，平均开始经口进食时间为3.3天，平均静脉使用镇痛药时间为5.0天。单孔和多孔病例之间无统计学显著差异。
单孔腹腔镜手术在炎症性肠病患者中技术上可行。住院时间和静脉使用镇痛药的天数似乎高于单孔腹腔镜结直肠手术可比系列研究中的结果，且结果与多孔腹腔镜手术相当。这可能是由于炎症性肠病的性质，限制了该人群单孔手术的益处。
