腹腔镜结肠切除术中肠系膜缺损闭合的临床意义：一项单机构队列研究
Clinical Significance of Closure of Mesenteric Defects in Laparoscopic Colectomy: A Single-Institutional Cohort Study.
作者信息
Sugiyama Masahiko, Sakaguchi Yoshihisa, Oki Eiji, Kusumoto Eiji, Ota Mitsuhiko, Kimura Yasue, Tsutsumi Norifumi, Kusumoto Tetsuya, Ikejiri Koji, Maehara Yoshihiko
机构信息
*Department of Gastroenterological Surgery, Clinical Research Institute Cancer Research Division, National Kyushu Medical Center †Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2016 Feb;26(1):82-5. doi: 10.1097/SLE.0000000000000234.
BACKGROUND
The effect of closure of mesenteric defects to prevent complications, such as internal hernia, during laparoscopic colectomy remains controversial and is a subject of debate.
PURPOSE
This retrospective single-institution study aimed to clarify the clinical significance of mesenteric defect closure during a laparoscopic colectomy.
METHODS
We evaluated 58 patients who underwent laparoscopic right-side colectomy or transverse colectomy. The statistical relevance of complications, surgical maneuvers, and clinical factors was examined.
RESULTS
The mesenteric defects were closed in 30 patients and not closed in 28 patients. Two patients with ileus and 1 with a deep incisional surgical site infection required a second surgery. The reoperation rate was significantly higher in the nonclosure group than in the closure group (11% vs. 0%, respectively; P=0.033).
CONSIDERATION
Serious complications requiring reoperation occurred only in the nonclosure group. The procedure for closing the defect did not extend the operation time or increase the bleeding.
背景
在腹腔镜结肠切除术中，关闭肠系膜缺损以预防诸如内疝等并发症的效果仍存在争议，是一个备受争论的话题。
目的
这项回顾性单机构研究旨在阐明腹腔镜结肠切除术中肠系膜缺损关闭的临床意义。
方法
我们评估了58例行腹腔镜右侧结肠切除术或横结肠切除术的患者。对并发症、手术操作和临床因素的统计学相关性进行了检查。
结果
30例患者的肠系膜缺损被关闭，28例未关闭。2例肠梗阻患者和1例深部手术切口感染患者需要二次手术。非关闭组的再次手术率显著高于关闭组（分别为11%和0%；P=0.033）。
结论
仅在非关闭组发生了需要再次手术的严重并发症。关闭缺损的操作未延长手术时间或增加出血量。
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