| Avtor/Urednik | Baca, Ivo; Schultz, Christian; Goetzen, Volker | |
| Naslov | Laparoscopic-assisted colorectal surgery | |
| Prevedeni naslov | Laparoskopsko asistirana kirurgija širokega črevesa in danke | |
| Tip | članek | |
| Vir | Endoskopska revija | |
| Vol. in št. | Letnik 3, št. 5 | |
| Leto izdaje | 1998 | |
| Obseg | str. 9-17 | |
| Jezik | eng | |
| Abstrakt | A prospective study was performed to evaluate the safety and effectiveness of laparoscopic-assisted colorectal surgery for benign and malignant diseases. The operation was completed laparoscopically in 196 of the 210 patients operated on since 1993 (conversion rate 6.7%). The operations included hemicolectomies, sigmoid resections, low anterior (conversion rate 6.7%). The operations included hemicolectomies, sigmoid resections, low anterior resections, abdominoperineal resections, Hartmann's closures, proctocolectomies and rectopexies. One hundred of the successfully completed cases were operated on for benign, and 96 for malignant diseases. The average operating time was 140+-55 min, and the duration of postoperative hospital stay 12+-6 days. Oral food intake was started on the second postoperative day without major problems. Perioperative complications occurred in 35 cases (18%). There were 7 anastomotic leaks (3.6%), 13 wound infections (6.6%), one pneumothorax and 3 postoperative bleedings, 2 of which reguired reoperation. Four patients died as a consequence of anastomotic leaks, and 3 of other causes (mortality 3.6%). This series showed a considerably faster recovery, decreased postoperative pain and reduced complication rate as comapred to patients undergoing conventional surgeru. The number of lymph nodes harvested (average 11+-4), aadequate resection marigns and the size of resected specimens in patients with malignant condition indicate that laparoscopic-assisted colorectal surgery and conventional surgery follow similar oncologic criteria. Furthermore, no rise in the recurrence rate was observed during the follow-up period compared to conventional surgery. Reduced morbidity, less abdominal pain and faster recovery are the main arguments in favor of laparoscopic-assisted colorectal surgery. | |
| Izvleček | V perspektivni raziskavi je bila ovrednotena varnost in učinkovitost laparoskopsko asistiranih operacij pri benignih in malignih boleznih širokega črevesa in danke. Vključenih je bilo 210 bolnikov, operiranih po letu 1991. Pri 196 bolnikih je bila operacija tudi laparoskopsko dokončana (preklop v 6,7%). Opravljeni so bili naslednji operativni posegi: hemikolektomija, resekcija sigme, nizka sprednja resekcija, Hartmannova operacija, proktokolektomija in rektopeksija. Sto operacij je bilo opravljenih pri benignih boleznih, 96 pa zaradi malignoma. Povprečno trajanje operacij je bilo 140+-55 minut, trajanje pooperacijske hospitalizacije pa 12+-6 dni. Bolnike smo drugi dan po operaciji pričeli hraniti in pri tem ni bilo zapletov. Pri 35 bolnikih je po operaciji prišlo do zapletov (18%). Pri 7 bolnikih so puščale anastomoze (3,6%), pri 13 se je zagnojila rana (6,6%), pri enem bolniku se je razvil pnevmotoraks, pri 3 bolnikih je prišlo do krvavitve, ki smo jo dvakrat morali ustaviti s ponovno operacijo. 4 bolniki s puščanjem anastomoze so umrli, 3 pa smo izgubili iz drugih razlogov (smrtnost 3,6%). Opazovali smo hitrejše okrevanje in manj zapletov v primerjavi s klasično operiranimi bolniki. Bolečine po operaciji so bile manj intenzivne in kratkotrajnejše. Pri bolnikih z malignomi smo v povprečju resecirali 11+-4 bezgavk. Tudi zadovoljiv varnosti rob in dolžina reseciranega preparata potrjujeta, da laparoskopsko asistirani posegi izpolnjujejo onkološka načela. Pri sledenju bolnikov doslej nismo opazili ponovitve bolezni. Skrajšana obolevnost, manjše bolečine in hitrejše okrevanje so argumenti, ki govore v prid laparoskopsko asistiranim operacijam širokega črevesa in danke. | |
| Deskriptorji | COLORECTAL NEOPLASMS COLONIC DISEASES RECTAL DISEASES SURGERY, LAPAROSCOPIC POSTOPERATIVE COMPLICATIONS TREATMENT OUTCOME |