Milsom J W, Lavery I C, Church J M, Stolfi V M, Fazio V W
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44195-5044.
Dis Colon Rectum. 1994 Mar;37(3):215-8. doi: 10.1007/BF02048157.
This study evaluated the feasibility and safety of laparoscopic bowel surgery performed by colorectal surgeons not previously experienced in laparoscopic biliary or appendiceal surgery.
Thirty-two patients underwent ileocolic resection/anastomosis (n = 12), loop ileostomy (n = 7), colostomy (n = 4), ileostomy takedown/ileorectal anastomosis (n = 3), subtotal colectomy/ileorectal anastomosis (n = 2), sigmoid resection (n = 2), or other procedures (n = 2). No curative cancer surgery was undertaken.
Time to first bowel movement was one to eight (median, four) days. Length of stay ranged from 4 to 11 (median, 6) days. There were no major complications seen in follow-up from 6 to 15 (median, 7) months after surgery.
Large intestinal and distal ileal surgery using laparoscopic techniques, performed by surgeons with training only in laparoscopic intestinal surgery, is feasible and safe. Faster recovery and need for less postoperative analgesia in laparoscopic surgery compared with conventional surgery cannot be surmised from this study. A randomized study design is needed to evaluate many of the differences between conventional and laparoscopic intestinal surgery.
本研究评估了由之前未进行过腹腔镜胆道或阑尾手术的结直肠外科医生实施腹腔镜肠道手术的可行性和安全性。
32例患者接受了回结肠切除/吻合术（n = 12）、回肠袢造口术（n = 7）、结肠造口术（n = 4）、回肠造口关闭/回直肠吻合术（n = 3）、次全结肠切除/回直肠吻合术（n = 2）、乙状结肠切除术（n = 2）或其他手术（n = 2）。未进行根治性癌症手术。
首次排便时间为1至8天（中位数为4天）。住院时间为4至11天（中位数为6天）。术后6至15个月（中位数为7个月）的随访中未发现重大并发症。
仅接受过腹腔镜肠道手术培训的外科医生采用腹腔镜技术进行大肠和回肠远端手术是可行且安全的。本研究无法推测出与传统手术相比，腹腔镜手术恢复更快且术后镇痛需求更少。需要采用随机研究设计来评估传统和腹腔镜肠道手术之间的诸多差异。
