Single-incision laparoscopic stoma creation: Experience with 31 consecutive cases
Single-incision laparoscopic stoma creation: Experience with 31 consecutive cases
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DOI：
10.1111/ases.12034
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发表时间：
2013-08-01
影响因子：
1
通讯作者：
Nezu, Riichiro
中科院分区：
文献类型：
--
作者：
Hasegawa, Junichi;Hirota, Masaki;Nezu, Riichiro
简介：可以使用各种技术进行粪便转移。每种技术都有影响患者选择的优点。在本报告中，我们报告了 31 名患者接受单切口腹腔镜造口创建的经验，仅使用预先选定的造口部位作为端口进入点。方法：在先前标记的造口部位切开 2.5 厘米的皮肤切口，并将两个 5 毫米套管针通过造口部位放入腹部。仅当需要移动肠道或需要分离粘连时，才在造口部位插入可选的第三个套管针。经过充分的腹腔内探查后，将选定的肠环带到造口部位，然后使用标准技术使造口成熟。结果：2009年4月至2012年3月期间，31名平均年龄为68岁（范围为46-87岁）的患者（19名男性）接受了单切口腹腔镜造口创建。粪便改道包括回肠造口术 (n = 18) 和结肠造口术 (n = 13)。无术中并发症。两名患者 (6.5%) 需要在中线耻骨上区域放置额外的端口。由于存在广泛粘连，两名患者 (6.5%) 需要转为开腹手术。在两名患者中观察到术后并发症，包括造口周围肠梗阻和由于回肠造口量高而导致的脱水。结论：单切口腹腔镜造口创建是一种有效的技术，可以实现腹腔内的完全可视化和肠道动员，同时减少造口部位以外额外皮肤切口的需要。
Introduction: Fecal diversion may be performed using various techniques. Each technique has advantages that affect patient selection. In this report, we report our experience with 31 patients who underwent single-incision laparoscopic stoma creation using only a pre-selected stoma site as the point of port access.Methods: A 2.5-cm skin incision was made at a previously marked stoma site, and two 5-mm trocars were placed into the abdomen through the stoma site. An optional third trocar was inserted at the stoma site only if the bowel needed to be mobilized or if adhesions needed to be divided. After full intra-abdominal exploration, a selected intestinal loop was brought up to the stoma site, and the ostomy was then matured using standard techniques.Results: Between April 2009 and March 2012, 31 patients (19 men) with a mean age of 68 years (range, 46-87 years) underwent single-incision laparoscopic stoma creation. Fecal diversion included ileostomy (n = 18) and colostomy (n = 13). There were no intraoperative complications. Two patients (6.5%) required additional port placement in the midline suprapubic area. Conversion to open laparotomy was required in two patients (6.5%) because of the presence of extensive adhesions. Postoperative complications were observed in two patients and included peristomal ileus and dehydration due to high ileostomy output.Conclusions: Single-incision laparoscopic stoma creation is an effective technique that allows full intra-abdominal visualization and bowel mobilization, while reducing the need for additional skin incisions beyond that of the stoma site.