- 期刊
Laparoscopic Surgery in the Treatment of Iatrogenic Colonoscopic Perforation
以腹腔鏡手術治療大腸鏡造成的醫源性大腸穿孔
摘要
目的 大腸穿孔是大腸鏡造成的最嚴重併發症之一。標準的治療方式是手術介入。這個研究的目的是評估以腹腔鏡手術治療大腸鏡造成的醫源性大腸穿孔的癒後。方法 針對2003年1月至2010年12月間，連續的12位以腹腔鏡手術治療因大腸鏡造成醫源性大腸穿孔的病人資料，進行病例記錄的回溯性研究。結果 12位病人的平均年齡是56歲，其中八位病人為男性。有八位病人是因為接受息肉切除等治療性大腸鏡術式所造成。乙狀結腸是穿孔最常見之處。穿孔的大小平均是2公分，平均手術時間為110分鐘。手術的術式包括：腹腔鏡直接修補（9例）和大腸切除及縫合（3例）。沒有病人需要術中轉換成傳統剖腹探查或是需要大腸改道。有一位病人發生傷口感染的手術併發症。沒有因手術造成死亡病例發生。結論 熟練的醫師以腹腔鏡手術修補大腸造成的大腸穿孔是一個開腹手術之外另一個可行的選擇。
並列摘要
Purpose: Colonic perforation is one of the most serious complications of colonoscopy. Surgical intervention is the standard treatment. The aim of our study was to assess the outcome of laparoscopic surgery in the treatment of iatrogenic colonoscopic perforation.Methods: From January 2003 to December 2010, data of 12 consecutive patientswho had undergone laparoscopic surgery for iatrogenic colonoscopic perforation was collected for retrospective review.Results: Eight patients were men; the mean age of the 12 patients was 56 years. Eight patients had received therapeutic procedures in the form of a polypectomy. Most of the perforation sites were in the sigmoid colon (n = 8). The mean perforation size was 2 cm and mean operative time was 110 minutes. The operative procedure included primary repair (n = 9) and resection with anastomosis (n = 3). No conversion or colonic diversion was needed. One surgical complication of wound infection was detected. There was no surgical mortality.Conclusion: Laparoscopic surgery on colonoscopic perforations, in experienced hands, is a viable alternative to the open approach.
延伸閱讀
- Wang, C. H., Lin, Y. M., Chen, H. H., Chang, C. L., Lee, K. C., Tsai, K. L., & Lu, C. C. (2015). 於大腸直腸治療使用單孔腹腔鏡手術對上傳統腹腔鏡：惡性腫瘤預後之比較. 中華民國大腸直腸外科醫學會雜誌, 26(4), 142-149. https://doi.org/10.6312/SCRSTW.2015.26(4).10409
- Chen, Y. C., Tsai, Y. Y., Chang, S. J., Ke, T. W., Chen, H. C., Wang, H. M., & Chen, W. T. L. (2019). 腹腔鏡前位切除併發大腸壞死並以腹腔鏡Retroileal Transmesenteric Colorectal Anastomosis處理. 中華民國大腸直腸外科醫學會雜誌, 30(2), 84-88. https://doi.org/10.6312/SCRSTW.201906_30(2).10803
- Cheng, H. Y., Shih, S. C., Chang, W. H., Lin, C. C., Chu, C. H., & Wang, T. E. (2009). 大腸鏡與鋇劑灌腸X光攝影時所造成的大腸穿孔之臨床結果. 臺灣消化醫學雜誌, 26(2), 180-187. https://doi.org/10.6557/GJT.200906_26(2).0006
- Hsu, Y. S., Chen, H. C., Huang, T. M., You, J. J., Chang, T. C., Ke, T. W., & Lin, T. C. (2010). 以腹腔鏡直接修補醫源性結腸穿孔. 中華民國大腸直腸外科醫學會雜誌, 21(1), 29-36. https://doi.org/10.6312/SCRSTW.2010.21(1).09815
- Huang, K. C., Chen, Y. J., & Liang, J. T. (2015). 以腹腔鏡手術來治療同時存在之多發性大腸直腸腫瘤. 中華民國大腸直腸外科醫學會雜誌, 26(4), 123-128. https://doi.org/10.6312/SCRSTW.2015.26(4).10313