Lumley J W, Fielding G A, Rhodes M, Nathanson L K, Siu S, Stitz R W
Department of Surgery, Royal Brisbane Hospital, Herston, Australia.
Dis Colon Rectum. 1996 Feb;39(2):155-9. doi: 10.1007/BF02068069.
To audit the development and outcomes of laparoscopic colorectal surgery at the Royal Brisbane Hospital.
Since July 1991, laparoscopic-assisted colectomy for benign and malignant colorectal disease has been performed on more than 300 patients at the Royal Brisbane Hospital. This paper summarizes the outcome for the first 240 patients who underwent a laparoscopic colorectal procedure. All laparoscopic data were collected prospectively, and for selected studies, data were compared with open surgical controls.
Nineteen patients required open conversion (7.9 percent). There was a significant decrease in wound infection rates in patients having a laparoscopic-assisted colectomy (3.6 percent) compared with historical controls (7.9 percent) (P < 0.05; chi-squared). There were five anastomotic leaks, five laparotomies for postoperative adhesive obstruction, and four perioperative deaths. A total of 103 patients had a procedure for colorectal cancer. Of the 79 potentially curative procedures, there have been 5 (6.3 percent) recurrences to date.
The overall morbidity and mortality in this series seem to be acceptable compared with that of open procedures.
评估皇家布里斯班医院腹腔镜结直肠手术的开展情况及治疗效果。
自1991年7月起，皇家布里斯班医院已为300多名患有良性和恶性结直肠疾病的患者实施了腹腔镜辅助结肠切除术。本文总结了前240例接受腹腔镜结直肠手术患者的治疗结果。所有腹腔镜手术数据均为前瞻性收集，对于部分研究，将数据与开放手术对照组进行了比较。
19例患者需要转为开放手术（7.9%）。与历史对照组（7.9%）相比，接受腹腔镜辅助结肠切除术的患者伤口感染率显著降低（3.6%）（P<0.05；卡方检验）。发生了5例吻合口漏、5例因术后粘连性肠梗阻行剖腹手术以及4例围手术期死亡。共有103例患者接受了结直肠癌手术。在79例可能治愈的手术中，迄今为止有5例（6.3%）复发。
与开放手术相比，本系列手术的总体发病率和死亡率似乎是可以接受的。
