Nezhat C, Nezhat F, Ambroze W, Pennington E
Center for Special Pelvic Surgery, Atlanta, GA 30342.
Surg Endosc. 1993 Mar-Apr;7(2):88-9. doi: 10.1007/BF00704384.
This is a retrospective review of laparoscopic repair for enterotomies created during therapeutic or diagnostic laparoscopy in 26 women. All patients had mechanical and antibiotic bowel preparation preoperatively. The indication for operative laparoscopy was endometriosis (18), severe abdominal adhesive disease (7), and adhesions with Crohn's disease (1). Enterotomies were secondary either to CO2 laser vaporization or excision of endometriosis and/or lysis of adhesions (23) and trocar insertion (3). The injuries included small-bowel enterotomies (9), colotomies (4), and rectotomies (13). No clinical complications related to enterotomy repair were noted. Twenty-three patients were discharged 1 day after surgery; one was discharged on postoperative day 2; and two were discharged on postoperative day 3. We concluded that small- and large-bowel enterotomies can be repaired safely via the laparoscope with minimum morbidity in patients with prepared bowel.
这是一项对26名女性患者在治疗性或诊断性腹腔镜检查过程中所造成的肠切开术进行腹腔镜修复的回顾性研究。所有患者术前均接受了机械性肠道准备和抗生素肠道准备。手术腹腔镜检查的指征为子宫内膜异位症(18例)、严重腹部粘连性疾病(7例)以及克罗恩病粘连(1例)。肠切开术继发于二氧化碳激光汽化或子宫内膜异位症切除和/或粘连松解(23例)以及套管针插入(3例)。损伤包括小肠肠切开术(9例)、结肠切开术(4例)和直肠切开术(13例)。未发现与肠切开术修复相关的临床并发症。23例患者术后1天出院;1例术后第2天出院;2例术后第3天出院。我们得出结论,对于肠道已做好准备的患者,通过腹腔镜可以安全地修复小肠和大肠肠切开术,且发病率最低。