腹腔镜全结肠切除术在家族性腺瘤性结肠息肉病及溃疡性结肠炎中的临床应用

目的:探讨腹腔镜全结肠切除术在家族性腺瘤性结肠息肉病(familial adenomatous polyposis,FAP)及溃疡性结肠炎(ulcerative colitis,UC)治疗中的应用价值。方法:回顾分析2009～2012年为12例患者行腹腔镜全结肠切除术(FAP患者7例,UC患者5例)及18例传统开腹全结(直)肠切除术(FAP患者7例,UC患者11例)的临床资料。结果:腹腔镜组在切口长度、术中出血量、术后止痛药使用量、术后排气时间、拔除导尿管时间、术后住院时间等方面优于开腹组,住院总花费明显高于传统开腹手术。结论:腹腔镜全结肠切除术用于FAP及UC安全、可行,与传统开腹手术相比,具有患者创伤小、康复快等优点,手术效果不亚于传统开腹手术,具有较高的临床应用价值。

Clinical application of laparoscopic total colectomy in familial adenomatous polyposis and ulcerative colitis

Objective:To discuss the clinical application of laparoscopic total colectomy in familial adenomatous polyposis(FAP) and ulcerative colitis(UC),and compare laparoscopic technique with the open approach.Methods:A retrospective review was carried out including 30 patients who underwent laparoscopic total colectomy(5 UC patients and 7 FAP patients) or open technique(11 UC patients and 7 FAP patients) at qilu hospital of shandong university from year 2009 to 2012.Their clinical data were retrospectively analyzed.Results:Laparoscopic group showed advantageous against the open group at length of incision,estimated blood loss,postoperative analgesic usage,venting time,catheter extracting time and postoperative hospital stay,while costing more money.Conclusions:Laparoscopic total colectomy is safe and feasible when it is applied in FAP and UC.Comparing with the open technique,it means less invasion and accelerated recovery.At the same time its effect is not worse than that of the open approach.