CAJ | 학술논문

目的探讨完全腹腔镜结肠切除术中手工缝合重建的安全性与可行性.方法总结分析西京消化病医院结肠良性疾病(良性局部病变5例)和结肠癌(升结肠癌4例、横结肠癌2例和乙状结肠癌8例)共计19例连续病例应用手工缝合技术进行完全腹腔镜下肠道缝合重建的临床资料.所有患者均由同一组腹腔镜外科医生主刀完成手术,包括完全腹腔镜下结肠病灶局部切除手工肠道重建,右半结肠切除后回肠末端横结肠手工吻合及结肠的手工荷包缝合.结果完全腹腔镜结肠切除重建时,镜下手工缝合肠道重建11例,近端手工荷包缝合后环形吻合器吻合8例.镜下手工吻合时间为(49.5±29.4) min,荷包缝合时间为(13.3±5.5) min.术后未观察到吻合相关并发症.l例横结肠脂肪瘤患者术后发生轻度腹腔感染,经保守治疗后治愈.结论完全腹腔镜结肠切除术中手工缝合重建安全、可行；但需由经验丰富的腹腔镜外科医生实施.
목적 탐토완전복강경결장절제술중수공봉합중건적안전성여가행성.방법 총결분석서경소화병의원결장량성질병(량성국부병변5례)화결장암(승결장암4례、횡결장암2례화을상결장암8례)공계19례련속병례응용수공봉합기술진행완전복강경하장도봉합중건적림상자료.소유환자균유동일조복강경외과의생주도완성수술,포괄완전복강경하결장병조국부절제수공장도중건,우반결장절제후회장말단횡결장수공문합급결장적수공하포봉합.결과 완전복강경결장절제중건시,경하수공봉합장도중건11례,근단수공하포봉합후배형문합기문합8례.경하수공문합시간위(49.5±29.4) min,하포봉합시간위(13.3±5.5) min.술후미관찰도문합상관병발증.l례횡결장지방류환자술후발생경도복강감염,경보수치료후치유.결론 완전복강경결장절제술중수공봉합중건안전、가행；단수유경험봉부적복강경외과의생실시.
Objective To evaluate the safety and feasibility of hand-sewn anastomosis in totally laparoscopic colectomy.Methods Clinical data of 19 consecutive patients with benign (n=5) or malignant colonic diseases (n=14,4 ascending colon cancers,2 transverse colon cancers,and 8sigmoid colon cancers) treated with totally laparoscopic colectomy with a hand-sewn anastomosis were reviewed.All the procedures were performed by the same surgeon team including totally laparoscopic resection and hand-sewn anastomosis,ileocolic anastomosis after right hemicolectomy,and hand-sewn purse-string sutures in the colon.Results Hand-sewn anastomosis was performed for 11 patients and circular-stapled anastomosis with hand-sewn purse-string sutures was performed for other 8 patients.The mean hand-sewn anastomosis time was (49.5±29.4) min,and the mean hand-sewn purse-string sutures time was (13.3±5.5) min.No patients required conversion to laparoscopy-assisted or open surgery,and there were no postoperative complications related to anastomosis.One patient with transverse colon lipoma developed mild intra-abdominal infection after surgery and recovered after conservative treatment.Conclusion Totally laparoscopic intracorporeal hand-sewn anastomosis or hand-sewn purse-string sutures for colectomy is feasible and safe when performed by experienced laparoscopic surgeons.