胆囊瘘的腹腔镜治疗:初步经验

Q4 Medicine
J.A. Zapata-González , V. Corona-Montes , E.A. Ramírez-Pérez , D. López-Alvarado
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引用次数: 2

摘要

背景结肠憩室病在西方世界很常见。在首次憩室炎发作后,许多患者从药物治疗中获益,但10-20%的患者出现脓肿、梗阻或瘘管。目的探讨乙状结肠憩室病继发乙状囊瘘的腹腔镜治疗方法。材料与方法对2011-2015年连续10例患者进行观察性、回顾性研究:1)结肠瘘管切除术及膀胱乙状结肠一期闭合术或2)腹腔镜乙状结肠切除术及鼻技术(经肛门标本取出及结肠吻合术,一期闭合膀胱)。结果10例患者于2011年2月至2015年2月间手术。患者平均年龄为60.7(49 ~ 71)岁。乙状结肠切除一期吻合4例,乙状结肠切除一期吻合6例。手术时间140.4 (80-210)min,出血量195 (80-210)ml,开始口服饮食时间4.3 (3-5)d。所有患者均留置引流管10天,留置经尿道导尿管2周。截至目前,无一例患者出现瘘口复发或吻合肠吻合口狭窄的资料。结论使用腹腔镜治疗膀胱瘘的报告显示了可接受的结果。只有少数研究集中在膀胱瘘;一般来说,报告也包括其他类型的瘘(阴道瘘和皮肤瘘)。膀胱瘘是一种可以通过腹腔镜安全有效地解决的病理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tratamiento laparoscópico de las fístulas colovesicales: experiencia preliminar

Background

Diverticular disease of the colon is common in the western world. After the first episode of diverticulitis, many patients benefit from medical therapy, but 10-20% develop abscesses, obstruction, or fistula.

Aim

To describe the laparoscopic treatment of sigmoidovesical fistula secondary to diverticular disease.

Material and methods

An observational, retrospective study was conducted on 10 consecutive patients within the time frame of 2011-2015 that had undergone: 1) colovesical fistula resection and primary closure of the bladder and sigmoid colon or 2) laparoscopic sigmoidectomy with the NOSE technique (transanal extraction of the specimen and colorectal anastomosis with primary closure of the bladder).

Results

Ten patients were operated on within the time frame of February 2011 and February 2015. The mean age of the patients was 60.7(49-71) years. Sigmoidectomy with primary anastomosis was performed on 4 patients and resection and primary closure on 6 patients. Surgery duration was 140.4 (80-210) min, blood loss was 195 (80-210) ml, and length of time before beginning oral diet was 4.3 (3–5) days. The drain was left in place in all the patients for 10 days and the transurethral catheter for 2 weeks. Up to the present time, none of the patients has presented with fistula recurrence or data consistent with intestinal anastomosis stricture.

Conclusions

Reports on the use of laparoscopy for the treatment of colovesical fistulas have demonstrated acceptable results. Only a few studies concentrate exclusively on colovesical fistula; in general the reports include other types of fistula (colovaginal and colocutaneous), as well. Colovesical fistula is a pathology that can be resolved safely and efficaciously through laparoscopy.

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来源期刊
Revista mexicana de urologia
Revista mexicana de urologia Medicine-Urology
CiteScore
0.20
自引率
0.00%
发文量
49
期刊介绍: Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.
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