Serra-Aracil Xavier, Gil-Barrionuevo Esther, Martinez Eva, Mora-López Laura, Pallisera-Lloveras Anna, Serra-Pla Sheila, Puig-Divi Valenti, Navarro-Soto Salvador
Unidad de Cirugía Colorrectal, Departamento de Cirugía General y Ap Digestivo, Hospital Universitari Parc Taulí, Universitat Autonoma de Barcelona (UAB), Barcelona, España.
Unidad de Cirugía Colorrectal, Departamento de Cirugía General y Ap Digestivo, Hospital Universitari Parc Taulí, Universitat Autonoma de Barcelona (UAB), Barcelona, España.
Cir Esp (Engl Ed). 2021 Jan 20. doi: 10.1016/j.ciresp.2020.12.013.
Combined endoscopic and laparoscopic surgery (CELS) has emerged as a promising method for managing complex benign lesions that would otherwise require major colonic resection. The aim of this study was to describe the different techniques and to evaluate the safety of CELS, assess its outcomes in a technique that is scarcely widespread in our environment.
Observational retrospective study, short-term outcomes of patients undergoing CELS for benign colon polyps from October 2018 to June 2020 were evaluated. Postoperative outcomes, length of hospital stay and pathological findings were evaluated.
Seventeen consecutive patients underwent CELS during the study period. The median size of the lesion was 3.5 cm (range 2.5 - 6.5 cm), the most frequent location was the cecum (10 from 17). Most patients treated with CELS underwent an endoscopic-assisted laparoscopic wedge resection (11 from 17). In four patients this resection was combined with another CELS technique, and two patients underwent an endoscopic-assisted laparoscopic segment resection. The success rate of CELS in our series was in 14 from 17 (82,4%). The median operative time was 85 min (range 50-225 min). The median hospital stay was 2 days (range 1-15 days). One patient experienced an organ/space surgical site infection which did not require further intervention. Four lesions were shown to be malignant by postoperative pathology study.
CELS is a safe and multidisciplinar technique that requires collaboration between gastroenterologists and surgeons. It can be considered as an alternative to colonic resection for complex benign colonic polyps.
联合内镜与腹腔镜手术（CELS）已成为一种有前景的治疗复杂良性病变的方法，否则这些病变将需要进行大肠切除术。本研究的目的是描述不同的技术，并评估CELS的安全性，在我们所处环境中这种技术尚未广泛应用的情况下评估其疗效。
观察性回顾性研究，评估2018年10月至2020年6月期间接受CELS治疗良性结肠息肉患者的短期疗效。评估术后疗效、住院时间和病理结果。
在研究期间，17例患者连续接受了CELS治疗。病变的中位大小为3.5厘米（范围2.5 - 6.5厘米），最常见的部位是盲肠（17例中有10例）。大多数接受CELS治疗的患者接受了内镜辅助腹腔镜楔形切除术（17例中有11例）。4例患者的这种切除术与另一种CELS技术联合使用，2例患者接受了内镜辅助腹腔镜节段切除术。我们系列中CELS的成功率为17例中的14例（82.4%）。中位手术时间为85分钟（范围50 - 225分钟）。中位住院时间为2天（范围1 - 15天）。1例患者发生了器官/腔隙手术部位感染，无需进一步干预。术后病理研究显示4个病变为恶性。
CELS是一种安全的多学科技术，需要胃肠病学家和外科医生之间的合作。对于复杂的良性结肠息肉，它可被视为大肠切除术的一种替代方法。
