Hildebrandt U, Schiedeck T, Kreissler-Haag D, Lindemann W, Ecker K W, Bruch H P, Feifel G
Abteilung für Allgemeine Chirurgie, Abdominal-, und Gefässchirurgie, Universität des Saarlandes, Homburg/Saar.
Zentralbl Chir. 1998;123(4):357-61.
From Jan. 1993 to Apr. 1997 intestinal resections in Crohn's disease have been performed in 275 patients. 89 patients have been operated on laparoscopic assisted. The following parameters were analyzed: previous laparotomies, extent of resection, steroid medication, conversionrate, complications, operative time and postoperative stay. Endpoints were: conversionrate, complications, reconvalescence and overall satisfaction with the laparoscopic technique.
The duration of the disease ranged from 1 to 16 years (x = 6). 47 patients were under steroid medication at the time of surgery. 30 patients had undergone previous laparotomies. In 10 patients the operation had to be converted into open surgery. The following procedures have been performed: ileocaecal resections (45), anastomotic resections (14), small bowel resections (4), hemicolectomies (12), colectomies (9), loopileostomies (4), adhesiolysis (1). Minor complications occurred in 6.7% of patients, major complications in 5.6%. Operative time ranged from 70 to 420 minutes (x = 173.7). The postoperative hospital stay was 13.3 days in the average.
The morbidity of 12.3% is not higher than in open surgery. When complications do not occur the patients benefit from early convalescence, better cosmetics and shorter hospital stay.
1993年1月至1997年4月，对275例克罗恩病患者实施了肠道切除术。其中89例患者接受了腹腔镜辅助手术。分析了以下参数：既往开腹手术史、切除范围、类固醇药物使用情况、中转率、并发症、手术时间和术后住院时间。观察终点为：中转率、并发症、康复情况及对腹腔镜技术的总体满意度。
疾病病程为1至16年（平均6年）。47例患者在手术时正在使用类固醇药物。30例患者曾接受过开腹手术。10例患者手术中转开腹。实施了以下手术：回盲部切除术（45例）、吻合口切除术（14例）、小肠切除术（4例）、半结肠切除术（12例）、结肠切除术（9例）、袢式回肠造口术（4例）、粘连松解术（1例）。6.7%的患者发生轻微并发症，5.6%的患者发生严重并发症。手术时间为70至420分钟（平均173.7分钟）。术后平均住院时间为13.3天。
12.3%的发病率不高于开腹手术。若未发生并发症，患者可受益于早期康复、更好的美容效果和更短的住院时间。
