Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome
Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome
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DOI：
10.1007/s00464-010-1472-5
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发表时间：
2011-06-01
影响因子：
3.1
通讯作者：
D'Hoore, Andre
中科院分区：
文献类型：
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作者：
Wolthuis, Albert M.;Penninckx, Freddy;D'Hoore, Andre
腹腔镜乙状结肠切除术中经直肠取材避免了肌肉裂开切开取材。描述了一种经直肠标本提取技术，并介绍了一项关于可行性的初步研究结果。所有连续接受腹腔镜乙状结肠切除经直肠标本提取的患者都在这项观察性研究中。标本取回袋用于标本提取。所有的术前和手术数据、术后发病率和短期结果都被收集在一个数据库中。所描述的技术被用于治疗21名患者。患者的中位年龄为41岁(四分位数范围[IQR]，34-66岁)。中位体重指数(BMI)为23 kg/m(2)(IQR，22~26 kg/m(2))，90%为女性。在21例患者中，13例(62%)因子宫内膜异位症切除，5例(24%)因憩室病切除，3例(14%)接受肿瘤切除。中位手术时间105min(IQR，90~110min)，术中平均出血量10ml(IQR，0~20ml)。除1例(95%)在2 h内完成外，其余均在2 h内完成，标本平均长度为20 cm(IQR，13~25 cm)。有1例吻合口漏(5%)，经急诊剖腹手术和建立新的结直肠吻合口治疗。无一例患者需要临时改道造口，无术后死亡。中位住院天数为6天(IQR，5~7天)。所有患者在平均3.6个月的随访期内均恢复良好，无一例出现肛门功能障碍。腹腔镜乙状结肠切除术经直肠取材是可行的，近期效果良好。
Transrectal specimen extraction in laparoscopic sigmoid resection avoids a muscle-split incision for specimen retrieval. A technique for transrectal specimen extraction is described, and the results of a pilot study concerning feasibility are presented.All consecutive patients undergoing laparoscopic sigmoid resection with transrectal specimen extraction were included in this observational study. A specimen retrieval pouch was used to facilitate specimen extraction. All preoperative and operative data, postoperative morbidity, and short-term outcome were gathered in a database.The described technique was used to treat 21 patients. The median age of the patients was 41 years (interquartile range [IQR], 34-66 years). The median body mass index (BMI) was 23 kg/m(2) (IQR, 22-26 kg/m(2)), and 90% of the patients were women. Of the 21 patients, 13 (62%) underwent a resection for endometriosis, 5 (24%) had resection for diverticular disease, and 3 (14%) underwent a tumor resection. The median operating time was 105 min (IQR, 90-110 min), and the median intraoperative blood loss was 10 ml (IQR, 0-20 ml). All the procedures except one (95%) were performed within 2 h. The median length of the extracted specimen was 20 cm (IQR, 13-25 cm). There was one anastomotic leak (5%), treated by emergency laparotomy and creation of a new colorectal anastomosis. None of the patients required a temporary diverting stoma, and no postoperative mortality occurred. The median hospital stay was 6 days (IQR, 5-7 days). All the patients did well during a median follow-up period of 3.6 months, and none reported any anal dysfunction.Laparoscopic sigmoid resection with transrectal specimen extraction is feasible and has a good short-term outcome.