Chen H H, Wexner S D, Weiss E G, Nogueras J J, Alabaz O, Iroatulam A J, Nessim A, Joo J S
Department of Colorectal Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Fort Lauderdale, FL 33309, USA.
Surg Endosc. 1998 Dec;12(12):1397-400. doi: 10.1007/s004649900867.
The aim of this study was to evaluate disability after laparoscopic colectomy in patients with benign colorectal disease.
Patients who underwent laparoscopic colectomy for benign colorectal diseases were matched with patients who underwent laparotomy for the same diseases by the same surgeons during the same time period. A standardized questionnaire used to assess disability included days until return to partial activity, full activity, and work.
Seventy-one patients who underwent laparotomy were compared with 71 patients who underwent laparoscopy. Pathology included 26 patients with adenoma, 23 with Crohn's disease, 13 with diverticulitis, and 9 with reversal of Hartmann's procedure in each group. Procedures were partial colectomy with ileocolostomy, colocolostomy, or colorectostomy. There were no significant differences (p > 0.05) in age (55.8 vs. 59.7 years) or in the incidence of perioperative complications (25% vs. 29%) between the laparoscopy and laparotomy groups, respectively. The operative time was longer in the laparoscopic group than in the laparotomy group: 165 versus 122 min (p < 0.001). However, length of hospitalization, return to partial and full activity, and time off of work were significantly shorter in the laparoscopy than in the laparotomy group: 6.3 versus 9.0 days, 2.1 versus 4.4 weeks, 4.2 versus 10.5 weeks and 3.8 versus 7.5 weeks, respectively (p < 0.01 for all).
Laparoscopic colectomy for benign colorectal diseases was associated with significantly less disability than was laparotomy in terms of length of hospitalization as well as return to baseline partial and full activity and employment.
本研究旨在评估良性结直肠疾病患者行腹腔镜结肠切除术后的功能障碍情况。
将因良性结直肠疾病接受腹腔镜结肠切除术的患者与同期由同一外科医生为相同疾病行剖腹手术的患者进行匹配。用于评估功能障碍的标准化问卷包括恢复部分活动、完全活动和工作的天数。
71例行剖腹手术的患者与71例行腹腔镜手术的患者进行了比较。每组病理情况包括26例腺瘤患者、23例克罗恩病患者、13例憩室炎患者和9例行哈特曼手术逆转术的患者。手术方式为部分结肠切除术加回肠结肠吻合术、结肠结肠吻合术或结肠直肠吻合术。腹腔镜组与剖腹手术组在年龄（55.8岁对59.7岁）或围手术期并发症发生率（25%对29%）方面分别无显著差异（p>0.05）。腹腔镜组的手术时间比剖腹手术组长：165分钟对122分钟（p<0.001）。然而，腹腔镜组的住院时间、恢复部分和完全活动的时间以及休假时间均显著短于剖腹手术组：分别为6.3天对9.0天、2.1周对4.4周、4.2周对10.5周以及3.8周对7.5周（所有p<0.01）。
就住院时间以及恢复至基线部分和完全活动及工作情况而言，良性结直肠疾病行腹腔镜结肠切除术比剖腹手术导致的功能障碍明显更少。
