Laparoskopska hirurgija kolona i rektuma – naša iskustva nakon 60 učinjenih procedura
Sažetak
Uvod/Cilј. Laparoskopske operacije kolona i rektuma su široko prihvaćene i koriste se u tretmanu malignih i benignih oboljenja. Zbog značajno bržeg oporavka bolesnika sve veći broj hirurga uči i podržava ovu metodu. Cilj rada bio je da se utvrdi bezbednost minimalno invazivnog pristupa, kao i procena periopeativnih rezultata, onkoloških rezultata i postoperativnih podataka. Metode. Prospektivna opservaciona kohortna klinička studija je sprovedena na IV Odeljenju za kolorektalnu i pelvičnu onkološku hirurgiju Klinike za digestivnu hirurgiju – Prve hirurške Kliničkog Centra Srbije. Kod svih operisanih bolesnika analizirani su demografski podaci, patohistološke karakteristike tumora, vrsta hirurške intervencije, kao i rane postoperativne komplikacije. Rezultati. Laparoskopska kolorektalna resekcija je učinjena kod 60 bolesnika koji su imali maligne i benigne lezije. Njihova prosečna starost je iznosila 65 (29–87) godina. Operisano je 37 (62%) muškaraca i 23 (38%) žena. Zbog kolorektalnog karcinoma operisana su 43 (71,6%), zbog polipa 12 (20%) i Kronove bolesti 5 (8,3%) bolesnika. Kod bolesnika sa kolorektalnim karcinomom, prosečno je odstranjeno 22,5 (6–52) limfnih nodusa. Negativne hirurške margine su postignute kod svih bolesnika sa karcinomima. Dužina hospitalizacije je iznosila 5 (4–12) dana. Postoperativne komplikacije su zabeležene kod 5 (8,3%) bolesnika. Zabeležen je jedan smrtni ishod (1,7%) zbog tromboembolije. Zaklјučak. Ova studija je pokazala da se laparoskopska kolorektalna hirurgija može bezbedno izvoditi, uz nizak procenat postoperativnih komplikacija, kratko vreme boravka u bolnici, uz adekvatnu hiruršku resekciju i broj odstranjenih limfnih nodusa.
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