Avtor/Urednik		Breznikar, Brane
Naslov		Laparoskopska kirurgija širokega črevesa v SB Slovenj Gradec
Prevedeni naslov		Laparoscopic colon surgery in the Slovenj Gradec general hospital
Tip		članek
Vir		Endoskopska revija
Vol. in št.		Letnik 11, št. 25
Leto izdaje		2006
Obseg		str. 37-40
Jezik		slo
Abstrakt		Background. This article presents our experience with laparoscopic operations of the colon performed at the Department of General and Abdominal Surgery, Slovenj Gradec General Hospital, in the past five years (2001-2005). In patients selected for laparoscopic surgery during this period, laparocopy was converted to an open procedure as soon as operative problems with the minimally invasive approach arose. Patients and methods. We operated on 63 patients, 27 females and 36 males, aged 24 to 84 years. Large bowel malignomas were diagnosed in 32 patients, and benign lesions of the colon in 31. In the group operated on for benign colon diseases, 26 patients underwent resection, three adhesiolysis and two rectopexy. Among the patients operated on for large bowel malignomas, three received a paliative procedure, six right hemicolectorny, two left hemicolectomy, 12 low anterior resection and nine segmental resection. The principles of oncologlic surgery were followed in all patients operated on for malignant diseases. Results. Conversions were reguired in 11 (17%) cases: in two patients with benign lesions and in nine with malignant disease. Postoperative complications occurred in nine (14.3%) patients reguiring reoperation: three for dehiscence, two for ileus, one for stenosis, one for rectovaginal fistula, one for intraabdominal sbsces, and one, or peritonitis. At the time of reporting, 25 (78%) of the 32 patients operated on for colon cancer were free of symptoms. There were no recurrences; disease progression was noted in three patients; four patients died. Conclusions. Our results indicate that laparoscopic colon surgery is a technically feasible and effective operative procedure. (Abstract truncated at 2000 characters)
Izvleček		Izhodišča. V članku so prikazani rezultati laparoskopske kirurgije širokega črevesa na Oddelku za splošno in abdominalno kirurgijo Splošne bolnišnice Slovenj Gradec v obdobju zadnjih pet let (2001-2005). Za laparoskopski poseg smo bolnike izbirali, za konverzijo v klasični poseg pa smo se odločili, če ni bilo primernih pogojev za minimalno invazivni poseg. Bolniki in metode. Operirali smo 63 bolnikov, 27 bolnic in 36 bolnikov, starih od 24 do 84 let. 32 bolnikov smo operirali zaradi malignih tumorjev, 31 bolnikov pa zaradi benigne bolezni širokega črevesa. Pri bolnikih z benigno boleznijo smo naredili 24 resekcij širokega črevesa, 3 adheziolize, dve pogreznitvi izpeljanega črevesa in dve rektopeksiji. Pri treh bolnikih z malignomom širokega črevesa smo naredili paliativni poseg, pri 6 bolnikih desne hemikolektomijo, pri 2 bolnikih levo hemikolektomijo, pri 12 bolnikih nizko sprednjo resekcijo in pr 9 bolnikih segmentno resekcijo širokega črevesa. Pri vseh bolnikih operiranih zaradi maligne bolezni širokega črevesa smo sledili onkološkim načelom operiranja. Rezultati. Pri 11 (17%) bolnikih smo se odločili za preklop v klasični poseg (2 pri benigni in 9 pri maligni patologiji). Pri 9 (14,3%) bolnikih so se pojavili pooperativni zapleti, zaradi katerih je bi potreben ponovni kirurški poseg: 3 dehiscence, 2 ileusa, stenoza, rektovaginalna fistula, intraabdominalni absces in peritonitis. Zaključek. Naši rezultati potrjujejo, da je laparoskopsko zdravljenje bolnikov z benignimi in malignimi boleznimi širokega črevesa izvedljivo in uspešno. Pri večini bolnikov je okrevanje ugodnejše po laparoskopski v primerjavi s klasično metodo, zadovoljiva pa je tudi radikalnost in preživetje bolnikov operiranih zaradi malignih tumorjev širokega črevesa.
Deskriptorji		COLONIC DISEASES COLONIC NEOPLASMS LAPAROSCOPY TREATMENT OUTCOME