LAPAROSCOPIC-ASSISTED SEGMENTAL COLECTOMY - EARLY MAYO-CLINIC EXPERIENCE

被引:59
作者
DEAN, PA
BEART, RW
NELSON, H
ELFTMANN, TD
SCHLINKERT, RT
机构
[1] MAYO CLIN & MAYO FDN, DIV COLON & RECTAL SURG, ROCHESTER, MN 55905 USA
[2] MAYO CLIN & MAYO FDN, DEPT SURG, ROCHESTER, MN 55905 USA
[3] MAYO CLIN SCOTTSDALE, DIV COLON & RECTAL SURG, SCOTTSDALE, AZ USA
[4] MAYO CLIN SCOTTSDALE, DIV GEN SURG, SCOTTSDALE, AZ USA
关键词
D O I
10.1016/S0025-6196(12)61784-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To present a large initial series of patients who underwent laparoscopic-assisted segmental colectomy and to assess the feasibility and safety of this procedure. Design: We summarized the clinical outcome data for 122 Mayo Clinic patients selected for laparoscopic-assisted resection of the right, left, or sigmoid colon between 1991 and 1993. Material and Methods: Preexisting factors (such as obesity and prior abdominal operations), indications for surgical treatment, and intraoperative and postoperative complications were analyzed statistically in two groups of patients-those in whom the laparoscopic procedure was completed and those in whom conversion to an open surgical technique was necessary. Results: Laparoscopic-assisted colectomy was successfully completed for a variety of colonic pathologic conditions, including polyps, cancer, and diverticulitis. No operative deaths occurred in this series, and the overall complication rate was low (11%). Patients in whom laparoscopic-assisted colectomy was completed had a more rapid return of bowel function and a briefer hospital stay than did those who required conversion to the traditional open surgical technique. Neither obesity nor previous abdominal surgical procedures precluded successful laparoscopic-assisted colectomy, although the conversion rate to open colectomy was 75% in patients whose weight exceeded 90 kg. Conclusion: These findings indicate that laparoscopic-assisted segmental colectomy is safe and feasible, and the procedure may offer patient-related advantages. Oncologic concerns, including recent reports of trocar site recurrences, suggest a cautious approach to its application for resection of colonic cancer.
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页码:834 / 840
页数:7
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