Cinthya Cecilia Ulloa Abad, Dayana Belén Llumigusín Llumiquinga, Héctor Josué Ruano Imbaquingo, Robert Adan Lalama Rueda, Juan Esteban Lalama Rueda, José Daniel Nuñez Moreno, Iber Ivan Zambrano Zambrano
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引用次数: 0
Abstract
Minimally invasive surgery (MIS) is a groundbreaking approach for treating Crohn's disease (CD), affecting approximately 100-300 per 100,000 people. In 2015, an estimated 3.1 million people were diagnosed with Inflammatory Bowel Disease (IBD). Our research aims to consolidate previous evidence on MIS techniques, including laparoscopic techniques and robotic-assisted surgery, and compare them to traditional surgical techniques in managing CD. The practical benefits of MIS are evident in comparative studies, which consistently show that laparoscopic approaches result in shorter hospital stays and faster recovery than open surgery. MIS also demonstrates significant long-term benefits, particularly in reducing the mortality rate. Even pediatric CD patients have shown improved outcomes with laparoscopic-assisted surgery, experiencing fewer postoperative complications and better recovery. MIS applications include Laparoscopic ileocolic resections, a key MIS technique, offer comparable outcomes to other therapies like open ileocolic resection but with the added advantages of lower costs and long-term disease control. This cost-effectiveness of MIS techniques is a significant advantage. Techniques like intracorporeal anastomosis and trans colonic specimen removal have further improved postoperative recovery and cosmesis. Strictureplasty is another MIS technique, is particularly beneficial for CD patients with strictures due to its ability to preserve intestinal length and function. Lastly, laparoscopic robotic-assisted surgery is a game-changer, offering a significant reduction in postoperative pain and faster recovery compared to manual surgeries.
微创手术(MIS)是治疗克罗恩病(CD)的突破性方法,每十万人中约有 100-300 人患此病。2015年,估计有310万人被诊断患有炎症性肠病(IBD)。我们的研究旨在整合以往有关 MIS 技术(包括腹腔镜技术和机器人辅助手术)的证据,并将其与传统外科技术在治疗 CD 方面进行比较。MIS的实际优势在比较研究中显而易见,这些研究一致表明,腹腔镜方法比开腹手术住院时间更短,恢复更快。MIS 还具有显著的长期优势,尤其是在降低死亡率方面。即使是小儿 CD 患者也能通过腹腔镜辅助手术获得更好的治疗效果,术后并发症更少,恢复更好。MIS 的应用包括腹腔镜回肠结肠切除术,这是一项关键的 MIS 技术,其疗效与其他疗法(如开腹回肠结肠切除术)相当,但成本更低,而且能长期控制病情。MIS 技术的成本效益是其一大优势。体腔内吻合术和经结肠标本清除术等技术进一步改善了术后恢复和外观。肠狭窄成形术是另一种 MIS 技术,由于能够保留肠道长度和功能,因此对患有肠狭窄的 CD 患者特别有益。最后,与人工手术相比,腹腔镜机器人辅助手术能显著减少术后疼痛,加快术后恢复,是一项颠覆性技术。