[1]龚文敬,赵希忠,任叔阳,等.经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘10例报告[J].中国微创外科杂志,2017,17(1):72-88.
　Gong Wenjing,Zhao Xizhong,Ren Shuyang,et al.Transumbilical SILS-Port Laparoscopic-assisted Subtotal Colectomy for Slow Transit Constipation: Report of 10 Cases[J].Chinese Journal of Minimally Invasive Surgery,2017,17(1):72-88.
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经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘10例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年1期
页码:
72-88
栏目:
经验交流
出版日期:
2017-04-18

文章信息/Info

Title:
Transumbilical SILS-Port Laparoscopic-assisted Subtotal Colectomy for Slow Transit Constipation: Report of 10 Cases
作者:
龚文敬; 赵希忠; 任叔阳; 安辉; 蓝海波; 赵美珠; 杨向东﹡
成都肛肠专科医院便秘科，成都610015
Author(s):
Gong Wenjing;  Zhao Xizhong;  Ren Shuyang;  et al.
Department of Constipation, Chengdu Anorectal Hospital, Chengdu 610015, China
关键词:
经脐单孔SILS-Port; 经自然腔道内镜手术; 腹腔镜; 结肠次全切除术; 慢传输型便秘
Keywords:
Transumbilical SILS-Port; Natural orifice transluminal endoscopic surgery; Laparoscopy; Subtotal colectomy; Slow transit constipation
文献标志码:
B
摘要:
目的探讨经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘的安全性与可行性。方法2014年12月~2015年6月我院采用经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘10例，记录术后疼痛及腹壁美容满意度评分，采用Wexner便秘评分、便秘症状严重程度评分和胃肠生活质量指数评价便秘治疗的疗效。结果均顺利完成手术，手术时间（217±35）min，术中出血量(36±11)ml。均无术后出血、吻合口漏、腹腔感染、肠梗阻及肛门失禁等并发症发生。首次排气、排便时间分别为(2.4±0.8)d和(2.9±0.6)d，术后切口疼痛VAS评分（3.3±0.5）分，术后腹壁美容满意度评分（4.3±0.5）分。术后6个月Wexner便秘评分（4.5±1.0）分，显著低于术前（22.0±1.9）分（t=26.087，P=0.000）；便秘症状严重程度评分（5.5±0.5）分较术前（23.2±0.9）分，明显降低（t=52.836，P=0.000）；胃肠生活质量指数（105.7±3.9）分，较术前（77.4±6.0）分明显提高（t=-12.457，P=0.000）。结论经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘安全可行，腹壁美容效果好，近期疗效满意。
Abstract:
ObjectiveTo explore the safety and feasibility of transumbilical SILS-Port laparoscopic-assisted subtotal colectomy for treating slow transit constipation. Methods Clinical data of 10 patients with slow transit constipation who underwent transumbilical SILS-Port laparoscopic-assisted subtotal colectomy in our hospital were analyzed. The postoperative pain and abdominal beauty satisfaction score, Wexner constipation score, constipation severity score and gastrointestinal quality of life index (GIQLI) were recorded to evaluate the treatment efficacy. ResultsAll the operations were completed successfully without postoperative complications, such as postoperative bleeding, anastomotic fistula, abdominal infections, intestinal obstruction and incontinence. The operative time was (217±35) min, the blood loss was (36±11) ml, the first time of exhaust and defecation were (2.4±08) d and (2.9±0.6) d, the postoperative pain and abdominal beauty satisfaction scores were (3.3±0.5) points and (4.3±0.5) points. The Wexner constipation score and symptom severity score were (4.5±1.0) points and (5.5±0.5) points, which were significantly lower than preoperative scores (t=26.087, P=0.000; t=52.836, P=0.000). The GIQLI was (105.7±3.9) points, which was significantly higher than that before operation ［(77.4±6.0） points, t=-12.457, P=0.000］. Conclusion Transumbilical SILS-Port laparoscopic-assisted subtotal colectomy for slow transit constipation is a safe and feasible procedure with good cosmetic satisfaction and excellent short-term effects.

参考文献/References:

[1]吴玉立,吕超,吴硕东.单孔腹腔镜结直肠手术的研究现状及进展.中国微创外科杂志,2013,13(7):659-661.
[2]汪飞,江志伟,黎介寿.单孔腹腔镜技术在胃结直肠手术中的应用.中国实用外科杂志,2010,30(6):501-502.
[3]Drossman DA. The functional gastrointestinal disorders and the Rome Ⅲ process. Gastroenterology,2006,130(5):1377-1390.
[4]中华医学会消化病学分会胃肠动力学组,中华医学会外科学分会结直肠肛门外科学组.中国慢性便秘诊治指南(2013,武汉).胃肠病学,2013,18 (10):605-612.
[5]罗金燕,王学勤,戴菲,等.慢传输型便秘结肠动力学研究.中华消化杂志,2002, 22(2):117-119.
[6]Downie WW, Leatham PA, Rhind VM, et al. Studies with pain rating scales. Ann Rheum Dis, 1978,37(4):378-381.
[7]黄致锟.单切口经脐腹腔镜胃旁路术与腹腔镜5孔胃旁路术的比较研究.中国微创外科杂志,2010,10(11):969-972．
[8]Agachan F, Chen T, Pfeifer J, et al. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum,1996, 39(6):681-685.
[9]Jayne DG, Schwandner O, Stuto A. Stapled transanal rectal resection for obstructed defecation syndrome: one-year results of the European STARR registry. Dis Colon Rectum,2009,52(7):1205-1214.
[10]Eypasch E, Williams JI, Wood-Dauphinee S, et al. Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg, 1995,82(2):216-222.
[11]胡三元.经自然腔道内镜技术和单孔腹腔镜技术在结直肠外科手术中的应用.中华胃肠外科杂志,2012,15(8):770-772.
[12]张一中,王小军,帅勇锋,等.自制单孔装置Iconport行腹腔镜胆囊切除术50例报告.中国微创外科杂志,2015,15(6):543-545.
[13]孙博,祖强,卢锦山,等.自制单孔多通道平台后腹腔镜技术在肾脏手术中的应用.中国微创外科杂志,2015,15(1):43-46.
[14]Bulian DR，Runkel N，Burghardt J,et al. Natural orifice transluminal endoscopic surgery (NOTES) for colon resections-analysis of the first 139 patients of the German NOTES Registry (GNR).Int J Colorectal Dis,2014,29(7):853-861.
[15]Kawahara H, Watanabe K, Tomoda M, et al. Single-incision clipless laparoscopic total colectomy.Hepatogastroenterology,2014,61(130):453-455.
[16]Fu T, Zhao S, Li F, et al. Single-incision laparoscopic subtotal colectomy with cecorectal anastomosis for slow transit constipation.Tech Coloproctol, 2016,20(2):135-137.
[17]Gandhi DP, Ragupathi M, Patel CB, et al. Single-incision versus hand-assisted laparoscopic colectomy: a case-matched series. J Gastrointest Surg,2010,14(12):1875-1880．
[18]Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case-controlled comparison. Ann Surg,2012,255(1):66-69．
[19]龚文敬,杨向东,宋崇林,等.腹腔镜辅助结肠次全切除经肛门取出标本治疗慢传输型便秘.中华胃肠外科杂志,2014,17(8):796-798.
[20]中华医学会外科学分会结直肠肛门外科学组.便秘外科诊治专家共识.中华胃肠外科杂志,2010,13(7):546-547.
[21]陈孝平,汪建平,主编.外科学.第8版.北京:人民卫生出版社,2013.423-424.

备注/Memo

备注/Memo:
﹡通讯作者，E-mail:y-xd@vip.163.com
更新日期/Last Update: 2017-04-18