Saba A K, Kerlakian G M, Kasper G C, Hearn A T
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio, USA.
J Laparoendosc Surg. 1995 Feb;5(1):1-6. doi: 10.1089/lps.1995.5.1.
Minimally invasive techniques are having an impact on a variety of surgical procedures. Before their widespread acceptance as the standard of care, studies need to document their efficacy in comparison to open techniques. This study compared 25 laparoscopic-assisted colectomies to 25 open colectomies all performed within the last five years by the same surgeon. In terms of adequacy of resection, laparoscopic assisted colectomy compared favorably with open colectomy in both length of resection (15.7 cm vs 19.3 cm) and average number of nodes (6 vs 10). In addition to lessening patient discomfort, the other advantages were earlier return of bowel function (regular diet postoperative day 2 vs postoperative day 5) and shorter length of stay (4 vs 8 days). Operating costs were significantly greater, but this was offset by the shorter length of stay. This study supports laparoscopic assisted colectomy as a technically safe procedure with substantial patient benefits.
微创技术正在对多种外科手术产生影响。在它们被广泛接受成为标准治疗方法之前,研究需要记录其与开放手术相比的疗效。本研究比较了同一外科医生在过去五年内进行的25例腹腔镜辅助结肠切除术和25例开放结肠切除术。在切除充分性方面,腹腔镜辅助结肠切除术在切除长度(15.7厘米对19.3厘米)和平均淋巴结数量(6个对10个)上与开放结肠切除术相比均表现良好。除了减轻患者不适外,其他优点还包括肠道功能恢复更早(术后第2天恢复正常饮食对术后第5天)和住院时间更短(4天对8天)。手术成本显著更高,但住院时间缩短抵消了这一因素。本研究支持腹腔镜辅助结肠切除术是一种技术上安全且对患者有诸多益处的手术。