腹腔镜灌洗引流在憩室病并发腹膜炎手术治疗中的应用

Chirurgia italiana Pub Date : 2009-07-01
Carlo Ettore Lippi, Luca Beatini, Silvio Cervia, Alaido Fabbricotti, Piero Antonio Miaruelli, Elisabetta Spessa, Ivarco Sturlese, Andrea Braini
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引用次数: 0

摘要

腹膜炎并发结肠憩室病的治疗尚未被普遍认为是既定的做法,各外科机构在管理上的主要差异是值得注意的。在急诊情况下,很少有外科医生采用微创入路,最常见的治疗选择是乙状结肠切除术加一期吻合(带或不带转移造口)和Hartmann手术。作者报告了13例腹腔镜下不切除结肠灌洗引流治疗憩室炎并发腹膜炎的初步经验,并描述了手术的技术细节。他们对文献进行了系统的回顾,并根据他们的最新经验,比较了传统切除手术(一期吻合切除和Hartmann手术)与腹腔镜保守和非切除治疗的结果。腹腔镜非切除手术减少了手术并发症的频率和严重程度,以及住院时间和治疗费用。综上所述,腹腔镜灌洗引流术可用于大多数患者,在单期手术中恢复前景良好,不致残造口。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Laparoscopic lavage and drainage in the surgical treatment of diverticular disease complicated by peritonitis].

The treatment of peritonitis complicating diverticular disease of the colon is yet to be universally regarded as established practice and major differences in management are to be noted in the various surgical institutions. In the emergency setting, the minimally invasive approach is used by few surgeons and the most frequent therapeutic options are sigmoid resection with primary anastomosis (with or without a diverting stoma) and Hartmann's procedure. The Authors report their preliminary experience (13 cases) with laparoscopic lavage and drainage without colonic resection in diverticulitis complicated by peritonitis and describe the technical details of the surgical procedure. They conduct a systematic review of the literature and, on the basis of their latest experience, compare the results of the traditional resective operations (resection with primary anastomosis and Hartmann's procedure) with those of laparoscopic conservative and non-resective treatment. Laparoscopic non-resective procedures reduce the frequency and severity of the surgical complications, as well as the hospital stay and costs of treatment. In conclusion, laparoscopic lavage and drainage can be used in the majority of patients, with excellent prospects of recovery, without disabling stomas, in a single operative stage.

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