- 期刊
Single-Site Laparoscopic Right Hemicolectomy: A Preliminary Report of 18 Cases
單一切口腹腔境右側結腸切除－初步18個病例分析
摘要
背景 許多文獻已經證實腹腔鏡結腸切除手術可以改善手術短期預後。目前更著重於侵入性更小的腹腔鏡外科發展，即單切口腹腔鏡手術（SSLS）。本報告是就單切口腹腔鏡右側結腸切除手術的短期手術預後評估。方法 本研究乃於單一醫學中心從2009年十一月至2010年二月止之治療經驗。研究對象僅限於升結腸腺瘤、憩室炎與盲腸腺癌，凡需進行急診手術或有阻塞之病人則被排除。所有的手術均由同一手術團隊完成，手術期間數據經事前收集及事後評估。結果 本研究共評估了18位單切口腹腔鏡右側結腸切除手術之病人，外科相關腫瘤成效為：平均遠端斷端距離腫瘤14.7公分，平均淋巴廓清19.5顆，平均術後2天排氣，術後住院日5天。有三位患者於術中改為使用傳統腹腔鏡手術。結論 我們初步的報告為使用單切口腹腔鏡右側結腸切除手術治療惡性大腸癌為安全又可行的方法，但是其真正的優點還不明確，需要更多前瞻性研究去評估其真正的價值。
並列摘要
Background. Since the introduction of laparoscopic colectomy, proof of improved short-term surgical results have been noted in many literatures. Therefore, current focus has shifted to reduce the invasiveness of laparoscopic surgery, resulting in the invention of single site laparoscopic surgery (SSLS). This study is to report our short-term surgical outcomes about SSLS right hemicolectomy.Methods. Patients were all collected from a single institution from November 2009 to February 2010. The inclusion criteria were only ascending colon adenocarcinoma, diverticulitis and cecal adenocarcinoma. Cases with emergent operations or colon obstructions were excluded. All surgical procedures were completed by the same laparoscopic team. Peri-operative data was collected prospectively, and retrospectively evaluated. Results. A total of 18 patients of SSLS right hemi-colectomy were included in this study. The surgical oncology results revealed that the length of distal cut margin was 14.7 cm, and numbers of harvested lymph nodes was 19.5. Days of flatus passage was 2 days. Postoperative length of hospital stay was 5 days. Three patients were converted to either traditional laparoscopic surgery or open surgery. Conclusion. Our preliminary experience with SILS right hemi-colectomy demonstrated the safety of the procedure and its feasibility in malignant colon cancer, but its' actual benefit is still uncertain. More experiences of SSLS and prospective trials are needed to validate its value and clearly define its role.
延伸閱讀
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