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单孔腹腔镜右半结肠切除术:一项系统评价

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review.

作者信息

Apostolou K G, Orfanos S V, Papalois A E, Felekouras E S, Zografos G C, Liakakos T

机构信息

1st Department of Surgery, General Hospital of Athens Laiko, Athens School of Medicine, University of Athens, Agiou Thoma 17, 11527 Athens, Greece.

1st Department of Propaedeutic Surgery, Athens Medical School, Hippocration Hospital of Athens, Athens, Greece.

出版信息

Indian J Surg. 2015 Aug;77(4):301-12. doi: 10.1007/s12262-015-1282-z. Epub 2015 Jun 10.

Abstract

As surgeons became more adept with laparoscopic colon surgery, other less invasive procedures, such as single-incision laparoscopic right hemi-colectomy (SIL-RH), have been applied. The objective of this study was to evaluate the safety of SIL-RH as well as its intraoperative and postoperative outcomes for right-sided colon diseases. A detailed search in PubMed for citations that included SIL-RH from 2000 to 2014 revealed 21 studies fulfilling the criteria of the present review. A total of 684 patients were analyzed. Of the patients, 50.2 % were men. Mean patient age was 64.8 years. Of the patients, 36.1 % had already undergone an abdominal operation before the performance of SIL-RH, while 69 % of the patients underwent SIL-RH for colon cancer. Relatively low rates of overall morbidity (15 %) and mortality (0.75 %) were reported in the included studies. Mean length of postoperative hospital stay (LOS) was 5.5 days. Bowel motility return had a mean value of 2.8 days. Mean number of harvested lymph nodes (LN) was 19.2 LN. All resection margins were tumor-free. SIL-RH was a safe alternative to multiport laparoscopic right hemi-colectomy (ML-RH) in terms of morbidity and mortality, postoperative gastrointestinal function recovery, LOS, as well as oncological radicalness.

摘要

随着外科医生对腹腔镜结肠手术操作愈发熟练,其他侵入性较小的手术,如单切口腹腔镜右半结肠切除术(SIL-RH),也得到了应用。本研究的目的是评估SIL-RH治疗右侧结肠疾病的安全性及其术中及术后效果。在PubMed中详细检索2000年至2014年包含SIL-RH的文献,共筛选出21项符合本综述标准的研究。对684例患者进行了分析。其中,男性患者占50.2%。患者平均年龄为64.8岁。36.1%的患者在接受SIL-RH手术前已接受过腹部手术,69%的患者因结肠癌接受SIL-RH手术。纳入研究报告的总体发病率(15%)和死亡率(0.75%)相对较低。术后平均住院时间(LOS)为5.5天。肠道蠕动恢复平均时间为2.8天。平均清扫淋巴结(LN)数量为19.2枚。所有切缘均无肿瘤。在发病率、死亡率、术后胃肠功能恢复、住院时间以及肿瘤根治性方面,SIL-RH是多端口腹腔镜右半结肠切除术(ML-RH)的一种安全替代术式。

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本文引用的文献

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