Zhu Pengcheng, Xing Chungen
Department of Colorectal Surgery, Second Hospital Affiliated to Soochow University, Suzhou, P.R. China.
J Minim Access Surg. 2017 Oct-Dec;13(4):256-260. doi: 10.4103/jmas.JMAS_230_16.
In this study, we aimed to evaluate the feasibility and safety of undergoing restorative proctocolectomy through ileal pouch-anal anastomosis (RPC-IPAA) with hand-assisted laparoscopic (HALS) in patients with ulcerative colitis (UC).
We reviewed 40 consecutive patients who underwent RPC-IPAA with HALS or open technique for treatment of UC between 2010 and 2013. Moreover, the intra-/post-operative outcomes were compared.
We found the median operative time was significantly longer in the HALS group while the blood loss was significantly less in patients with HALS than with open surgery. In the HALS group, the median duration of bed rest and the length of hospital stay were significantly shorter. Moreover, the rate of early post-operative complications in the HALS group was significantly less than that in the open surgery group, among which one patient died in the 30th day after surgery for the extensive use of steroids before the operation.
These findings clearly show that HALS RPC is safe and less invasiveness. HALS can become a more comfortable and standardised procedure for UC with the adoption of evolving technologies.
在本研究中，我们旨在评估溃疡性结肠炎（UC）患者通过手辅助腹腔镜下回肠袋肛管吻合术（RPC - IPAA）进行结直肠全切除回肠储袋肛管吻合术的可行性和安全性。
我们回顾了2010年至2013年间连续40例接受RPC - IPAA手术（采用手辅助腹腔镜技术或开放技术）治疗UC的患者。此外，对手术中及术后的结果进行了比较。
我们发现手辅助腹腔镜组的中位手术时间明显更长，而手辅助腹腔镜手术患者的失血量明显少于开放手术患者。在手辅助腹腔镜组中，中位卧床休息时间和住院时间明显更短。此外，手辅助腹腔镜组术后早期并发症发生率明显低于开放手术组，其中1例患者在术后第30天死亡，原因是术前大量使用类固醇。
这些结果清楚地表明，手辅助腹腔镜RPC是安全且侵袭性较小的。随着技术的不断发展，手辅助腹腔镜手术可为UC患者提供更舒适、标准化的手术方式。
