Department of Gastroenterological Surgery, Derince Teaching and Research Hospital, Kocaeli, Turkey.
Department of General Surgery, Derince Teaching and Research Hospital, Kocaeli, Turkey.
Turk J Gastroenterol. 2021 Aug;32(8):611-615. doi: 10.5152/tjg.2020.19835.
BACKGROUND/AIMS: Intussusception is a rare condition in adults which accounts for 1% of all intestinal obstructions. It usually requires surgical treatment and the classic approach is laparotomy. This article presented six adult patients who underwent laparoscopic surgery for intestinal obstruction due to intussusception.
Between January 2017 and July 2019, six adult patients underwent laparoscopic surgery for intestinal obstruction due to intussusception. The patients were evaluated in terms of presenting symptoms, diagnosis, treatment modality, morbidity, mortality and histopathological results.
All patients presented with acute (50%) or subacute (50%) symptoms. All patients had intestinal obstruction (partial, complete) findings. Intussusception was diagnosed by abdominal computed tomography (CT). The patients with ileocolic and colo-colonic intussusception underwent colonoscopy. In the preoperative period, the etiology of intussusception (neoplasm, idiopathic, etc.) was diagnosed only in one patient (16.6%). Two patients underwent laparoscopic segmental small bowel resection, two patients underwent laparoscopic right hemicolectomy, one patient underwent laparoscopic left hemicolectomy, and one patient underwent laparoscopic anterior resection. None of the patients developed intraoperative or postoperative complication. The histopathological examination revealed malignancy in two patients (33.3%).
CT is helpful in diagnosing of adult intussusception. However, it is usually difficult to define the underlying pathology with CT. Laparoscopic approach seems to be safe and effective as open surgery, both in diagnosis and treatment of intussusception.
背景/目的:成人肠套叠较为少见,占所有肠梗阻的 1%。肠套叠通常需要手术治疗,经典的方法是剖腹手术。本文介绍了 6 例因肠套叠导致肠梗阻而行腹腔镜手术的成年患者。
2017 年 1 月至 2019 年 7 月,6 例成年患者因肠套叠导致肠梗阻而行腹腔镜手术。评估患者的主要表现症状、诊断、治疗方式、发病率、死亡率和组织病理学结果。
所有患者均表现为急性(50%)或亚急性(50%)症状。所有患者均有肠梗阻(部分性、完全性)的表现。腹部 CT 诊断肠套叠。回肠-结肠型和结肠-结肠型肠套叠患者行结肠镜检查。在术前阶段,仅 1 例患者(16.6%)诊断出肠套叠的病因(肿瘤、特发性等)。2 例患者行腹腔镜节段性小肠切除术,2 例患者行腹腔镜右半结肠切除术,1 例患者行腹腔镜左半结肠切除术,1 例患者行腹腔镜前切除术。所有患者均未发生术中或术后并发症。组织病理学检查显示 2 例患者(33.3%)有恶性肿瘤。
CT 有助于诊断成人肠套叠。然而,CT 通常难以确定潜在的病理。与开放性手术相比,腹腔镜方法在诊断和治疗肠套叠方面似乎是安全有效的。