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炎症性肠病的单孔手术:当前证据综述

Single-Port Surgery in Inflammatory Bowel Disease: A Review of Current Evidence.

作者信息

de Groof E Joline, Buskens Christianne J, Bemelman Willem A

机构信息

Department of Surgery, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.

出版信息

World J Surg. 2016 Sep;40(9):2276-82. doi: 10.1007/s00268-016-3509-y.

Abstract

The majority of patients with Crohn's disease and up to 35 % of patients with ulcerative colitis will ultimately require surgery during the course of their disease. Over the past few years, surgical techniques and experience in minimal invasive surgery have evolved resulting in single-incision laparoscopic surgery. The aim of this approach is to diminish the surgical trauma by reducing the number of incision sites. This review discusses the benefits and disadvantages of single-port surgery in various procedures in patients with inflammatory bowel disease (IBD). Short-term postoperative results, functional outcome, and costs available in the literature will be discussed. Single-port surgery in IBD has several benefits when compared to multi-port laparoscopic surgery. By using fewer incisions, a potential reduction of postoperative pain with less morphine use can be accomplished. In addition, accelerated postoperative recovery can result in a shorter hospital stay. Furthermore, a superior cosmesis can be reached with placement of the port at the future ostomy site or at the umbilicus. Literature on single-port surgery in IBD consists mainly of case series and a few matched case series. These studies demonstrated that single-port surgery seems to be a safe and feasible approach for the surgical treatment of IBD patients.

摘要

大多数克罗恩病患者以及高达35%的溃疡性结肠炎患者最终在病程中需要接受手术治疗。在过去几年中,外科技术和微创手术经验不断发展,催生了单切口腹腔镜手术。这种手术方式的目的是通过减少切口部位数量来减轻手术创伤。本文综述讨论了单孔手术在炎症性肠病(IBD)患者各种手术中的利弊。将探讨文献中提供的术后短期结果、功能转归和费用情况。与多孔腹腔镜手术相比,IBD的单孔手术有诸多益处。通过减少切口数量,有可能减轻术后疼痛并减少吗啡用量。此外,术后恢复加快可缩短住院时间。而且,将端口置于未来造口部位或脐部可获得更好的美容效果。关于IBD单孔手术的文献主要是病例系列和一些匹配病例系列。这些研究表明,单孔手术似乎是治疗IBD患者的一种安全可行的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2177/4982875/2500ea6370ff/268_2016_3509_Fig1_HTML.jpg

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