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单切口腹腔镜手术治疗复杂性克罗恩病患者的可行性及短期临床疗效

The feasibility and short-term clinical outcomes of single-incision laparoscopic surgery for patients with complex Crohn's disease.

作者信息

Maeda Kiyoshi, Nagahara Hisashi, Shibutani Masatsune, Fukuoka Tatsunari, Nakao Shigetomi, Yamagami Hirokazu, Kamata Noriko, Muguruma Kazuya, Tanaka Hiroaki, Toyokawa Takahiro, Hirakawa Kosei, Ohira Masaichi

机构信息

Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.

Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.

出版信息

Surg Today. 2018 Feb;48(2):242-247. doi: 10.1007/s00595-017-1581-z. Epub 2017 Sep 13.

Abstract

PURPOSE

Single-incision laparoscopic surgery (SILS) offers excellent cosmetic results compared with conventional multi-port laparoscopic surgery. Recently, this technique has been applied to Crohn's disease (CD) with primary ileocolic strictures; however, the application of a laparoscopic approach for complex CD, which involves abscess formation, fistula formation, and recurrent CD, is controversial. The aim of this study was to investigate the safety and feasibility of SILS for patients with complex disease and to compare its clinical results in patients with complex disease vs. those with simple stricture disease.

METHODS

Fifty patients who underwent SILS for CD were divided into two groups: those with complex disease (complex group, n = 25), and those with simple strictures (simple group, n = 25). The preoperative data and clinical outcomes were analyzed and compared between the groups.

RESULTS

The operative time, blood loss and length of laparotomy incision were not significantly different between the groups. Although the rate of conversion and need for an additional port tended to be higher in the complex group, the rate of postoperative complications and length of hospital stay did not differ significantly between the groups.

CONCLUSION

SILS may be feasible for carefully selected patients with complex CD.

摘要

目的

与传统的多端口腹腔镜手术相比,单切口腹腔镜手术(SILS)具有出色的美容效果。最近,该技术已应用于患有原发性回结肠狭窄的克罗恩病(CD);然而,腹腔镜手术方法应用于涉及脓肿形成、瘘管形成和复发性CD的复杂性CD存在争议。本研究的目的是调查SILS对患有复杂性疾病患者的安全性和可行性,并比较其在复杂性疾病患者与单纯狭窄疾病患者中的临床结果。

方法

50例行SILS治疗CD的患者分为两组:患有复杂性疾病的患者(复杂组,n = 25)和患有单纯狭窄的患者(单纯组,n = 25)。分析并比较两组之间的术前数据和临床结果。

结果

两组之间的手术时间、失血量和剖腹手术切口长度无显著差异。虽然复杂组的中转率和额外端口的需求倾向于更高,但两组之间的术后并发症发生率和住院时间无显著差异。

结论

对于精心挑选的复杂性CD患者,SILS可能是可行的。

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