腹腔镜手术治疗溃疡性结直肠炎
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王德臣

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Laparoscopic surgery for ulcerative colitis
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    摘要:

    目的:探讨腹腔镜手术治疗溃疡性结直肠炎的可行性和安全性。
    方法:对腹腔镜手术治疗溃疡性结直肠炎5例患者的临床资料进行回顾性分析。
    结果: 5例均在腹腔镜下完成手术, 其中4例行全结直肠切除, 回肠储袋肛管吻合术(total proctocolectomy and ileal pouchanal anastomosis, IPAA), 1例行结肠次全全直肠切除, 盲肠肛管吻合术。中位手术时间7.5(6.5~9)h, 中位出血量250(150~400)mL, 中位术后进半流食时间62(60~86)h, 中位术后住院时间12(10~14)d。术后发生盆腔感染1例, 粘连性肠梗阻1例。随访中位时间22(10~34)个月, 大便平均每天6.5(4~10)次。日常生活自理, 工作正常, 无复发。
    结论:腹腔镜下溃疡性结直肠炎手术, 创伤小, 恢复快, 安全可靠, 但尚需进一步积累临床资料。

    Abstract:

    Objective:To investigate the feasibility and safety of laparoscopic surgical treatment of ulcerative colitis(UC).
    :Methods :The clinical data of 5 cases who underwent laparoscopic surgery for the treatment of ulcerative colitis were reviewed.
    :Results:All 5 cases successfully underwent laparoscopic surgery. Among them, 4 had total proctocolectomy and ileal pouchanastomosis(IPAA), and 1 had subtotal colectomy plus total proctectomy, and cecumanal anastomosis.The median operating time was 7.5(6.5-9)h, the median blood loss was 250(150-400)mL, the median time to begin semifluid intake after operation was 62(60-86)h, the median time of hospital stay was 12(10-14)d, Postoperative pelvic infection occurred in 1 case, adhesive intestinal obstruction occurred in another case. The median followup time was 22(10-34)months, and the average number of daily bowel movement was 6.5(4-10)d; they were relapsefree, and had normal daily living and work at followup.
    :Conclusions:Laparoscopic surgical treatment of ulcerative colitis is associated with minor trauma and rapid recovery, and is safe and reliable, but further accumulation of cases is required.

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陈写, 王德臣.腹腔镜手术治疗溃疡性结直肠炎[J].中国普通外科杂志,2008,17(12):8-118.
DOI:10.7659/j. issn.1005-6947.2008.12.008

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  • 在线发布日期: 2008-12-25