Laparoscopic colonic surgery - mission accomplished or work in progress?

被引:44
作者
Kehlet, H. [1 ]
Kennedy, R. H.
机构
[1] Rigshosp, Sect Surg Pathophysiol, Juliane Marie Ctr 4074, DK-2100 Copenhagen, Denmark
[2] Yeovil Hosp, Dept Surg, Yeovil, England
关键词
laparoscopic colonic surgery;
D O I
10.1111/j.1463-1318.2006.00955.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Laparoscopic colonic resection may facilitate early postoperative recovery due to reduced surgical stress, pain and ileus. However, large randomised studies have only shown marginal improvements in outcome compared with open surgery, reporting a median hospital stay of about 5-7 days. Concomitant with these developments multimodal rehabilitation, which involves a revision of general postoperative care principles, improved pain relief with epidural analgesia and early oral nutrition and mobilization, has demonstrated greater improvements in recovery after open surgery, resulting in a median hospital stay of about 2-4 days. Recent single centre, randomised studies where laparoscopic and open colonic resection are combined with multimodal rehabilitation have not resolved the debate regarding which is the optimal operative technique. Therefore, new strategies are required to integrate laparoscopy with multimodal rehabilitation in order to establish its advantages, cost effectiveness and indications in specific groups of patients or colorectal procedures, thus justifying widespread application of the laparoscopic technique.
引用
收藏
页码:514 / 517
页数:4
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