腹腔镜手术治疗结肠憩室病的方法
The laparoscopic approach in the treatment of diverticular colon disease.
作者信息
Carbajo Caballero M A, Martín del Olmo J C, Blanco J I, de la Cuesta C, Atienza R
机构信息
Department of Digestive Surgery, Medina del Campo Hospital, Valladolid, Spain.
出版信息
JSLS. 1998 Apr-Jun;2(2):159-61.
BACKGROUND AND OBJECTIVES
The experience with treatment of diverticular colon disease (DCD) by the laparoscopic method is analyzed.
METHODS
Between January 1994 and July 1997, a group of 22 patients with criteria for symptomatic diverticular disease in the descending and sigmoid colon underwent laparoscopy with average resections of 40 cm. Intra-abdominal mechanical anastomosis completed the procedure.
RESULTS
The operative morbidity was 28%. Two cases, in acute diverticulitis phase, were reconverted to open surgery, and three cases presented postoperative rectorrhagia which ceased spontaneously. No long-term complications have been found. Postoperative hospitalization was 4-8 days (mean 5.5) and mean operative time was 165 minutes (range 120-240).
CONCLUSIONS
Nevertheless, the learning curve precise to practice this type of surgery, the acceptable morbity-mortality rates which the laparoscopic method presents, especially with these high-risk groups of patients (age > 65, high blood pressure, etc), encouraged us to modified the criteria indicating surgery for the disease, offering first choice operative treatment with efficiency and safety. However, we feel that those patients with acute complications of diverticular colon disease must be excluded initially for laparoscopic approach.
背景与目的
分析腹腔镜治疗结肠憩室病（DCD）的经验。
方法
1994年1月至1997年7月，一组22例降结肠和乙状结肠有症状性憩室病标准的患者接受了腹腔镜检查，平均切除长度为40厘米。通过腹腔内机械吻合完成手术。
结果
手术发病率为28%。2例处于急性憩室炎阶段的患者转为开放手术，3例出现术后直肠出血，但自行停止。未发现长期并发症。术后住院时间为4 - 8天（平均5.5天），平均手术时间为165分钟（范围120 - 240分钟）。
结论
然而，开展这类手术所需的学习曲线、腹腔镜方法呈现的可接受的发病率 - 死亡率，特别是对于这些高危患者群体（年龄>65岁、高血压等），促使我们修改该疾病的手术指征标准，提供高效且安全的首选手术治疗。然而，我们认为结肠憩室病急性并发症患者最初必须排除在腹腔镜手术之外。
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