Laparoscopic subtotal colectomy for tuberculosis of colon: Report of 2 cases
- VernacularTitle:腹腔镜结肠次全切除术治疗结肠结核2例
- Author:
Dexing CHEN
;
Chunhe CAO
;
Jiachun DONG
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Colon;
Tuberculosis
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of laparoscopic subtotal colectomy on the basis of lesion identification with the combined use of laparoscopy and fibrocolonoscopy.Methods The operation was carried out under general anesthesia.The patients were maintained at a supine position.Four 10 mm trocars were introduced at the upper and lower borders of the umbilicus,and the left and right lower quadrants of the abdomen,respectively,and a 5 mm trocar was introduced at the right upper quadrant of the abdomen.The laparoscope was placed at the hypogastrium when performing right hemicolectomy,and at the left lower abdomen when left hemicolectomy.During the operation,a fibrocolonoscope was inserted by way of the severed end of the right colon for lesion identification.The colon was disconnected from the cecum to the sigmoid colon.Then the incision at the left lower abdomen was extended to 4 cm in length,and an extracorporeal ileosigmoidostomy was conducted. Results Pathologic changes of thickening and hardening intestinal walls were clearly observed under laparoscope.Fibrocolonoscopic examinations revealed that the false polyps and ulcers on the colonic mucosa had involved the descending colon and the part of the sigmoid colon.The operation time was 170 min and 190 min,respectively,and the intraoperative blood loss was 150 ml and 200 ml,respectively.Pathological examinations after the operation verified the presence of intestinal tuberculosis.No short-term complications occurred after the operation.The frequency of defecation was 5~6 times daily at short-term postoperative period and 1~2 times daily at 5~6 months after the operation.The patients' body weight increased by 2.5 kg and 4 kg,respectively. Conclusions Combined use of laparoscopy and fibrocolonoscopy can accurately evaluate the affected extent of the lesion.Laparoscopic subtotal colectomy is safe and feasible.
