Araki Y, Isomoto H, Tsuzi Y, Matsumoto A, Yasunaga M, Toh U, Yamauchi K, Shirouzu K
Department of Surgery, Kurume University Medical Center, Japan.
Kurume Med J. 1998;45(2):203-7. doi: 10.2739/kurumemedj.45.203.
Clinical aspects of laparoscopy combined total colectomy (LTC) (n = 10) and open total colectomy (OTC) (n = 29) with ileorectal anastomosis for familial adenomatous polyposis and ulcerative colitis are compared in a retrospective study. The mean operative time was 282 (range, 169 to 420) minutes in the LTC group and 274 (range, 139 to 570) minutes in the OTC group. The mean volume of operative blood loss was 321 (range, 52 to 728) ml and 471 (range, 48 to 1040) ml for the LTC and OTC groups, respectively. Nasogastoric tube could be removed after POD 1.2 vs. 5.8 (p < 0.05), the mean time to passage of stool was 1.9 (range, 1 to 3) vs. 5.2 (range, 3 to 7) days (p < 0.01), and in the LTC group watery stool was soon made solidification after POD 23.4 vs. 84.1 (p < 0.01). Laparoscopy combined total colectomy may prove to have one-stage restorative total colectomy without a temporary ileostomy due to early solidification of watery stool and more benefits than conventional open surgery.
在一项回顾性研究中，对腹腔镜联合全结肠切除术（LTC）（n = 10）和开腹全结肠切除术（OTC）（n = 29）行回直肠吻合术治疗家族性腺瘤性息肉病和溃疡性结肠炎的临床情况进行了比较。LTC组的平均手术时间为282（范围169至420）分钟，OTC组为274（范围139至570）分钟。LTC组和OTC组的平均术中失血量分别为321（范围52至728）ml和471（范围48至1040）ml。术后第1.2天与5.8天相比，LTC组可拔除鼻胃管（p < 0.05），LTC组平均排便时间为1.9（范围1至3）天，而OTC组为5.2（范围3至7）天（p < 0.01），且LTC组术后第23.4天与84.1天相比，水样便很快固化（p < 0.01）。腹腔镜联合全结肠切除术可能因水样便早期固化而无需临时回肠造口即可进行一期恢复性全结肠切除术，且比传统开腹手术有更多益处。
