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대장 및 소장 게실에서 표준 복강경수술과 수보조 복강경 수술의 비교

A Comparison of Standard Laparoscopic Surgery and Hand-Assisted Laparoscopic Surgery in Patients with Diverticular Diseases of the Large and the Small Bowel

대한대장항문학회지 2009년 25권 6호 p.380 ~ 386
정재학 ( Jung Jae-Hak ) - 을지대학교 의과대학 외과학교실

김창남 ( Kim Chang-Nam ) - 을지대학교 의과대학 외과학교실
박진석 ( Park Jin-Seok ) - 을지대학교 의과대학 외과학교실
김종엽 ( Kim Jong-Yup ) - 을지대학교 의과대학 외과학교실
조병선 ( Joe Byung-Sun ) - 을지대학교 의과대학 외과학교실
이민구 ( Lee Min-Koo ) - 을지대학교 의과대학 외과학교실
최영진 ( Choi Young-Jin ) - 을지대학교 의과대학 외과학교실
강윤중 ( Kang Yoon-Jung ) - 을지대학교 의과대학 외과학교실
박주승 ( Park Joo-Seung ) - 을지대학교 의과대학 외과학교실

Abstract


Purpose: In complicated diverticular disease, hand-assisted laparoscopic surgery (HALS) has been considered as a useful alternative treatment to standard laparoscopic surgery (SLS) and open surgery. As compared with standard laparoscopic surgery, HALS offers advantages such as tactile sense, better exposure, and shorter learning curve. Minimally invasive surgery is another advantage of HALS. The aim of this study was to compare SLS to HALS in patients with diverticular diseases of the small bowel and the colon.

Methods: We retrospectively reviewed the records of 32 patients who had undergone SLS and HALS for diverticular disease between February 2002 and March 2009.

Results: Of the 32 patients, 20 patients (62.5%) were in the SLS group, and 12 patients (37.5%) were in the HALS group. The mean maximal incision length was longer in the HALS group (SLS group vs. HALS group, 4.5 vs. 7.4 cm, P<0.001). However, the mean operating time, the time to flatus, the time to diet, the mean duration of narcotic analgesia, the length of hospital stay, and the postoperative complications were similar. There was no mortality in either group.

Conclusion: The longest incision length for the HALS group was longer than that for the SLS group, but HALS could reduce the conversion rate and has the many advantages of minimally invasive surgery. For complicated diverticular disease, HALS may be considered as a useful alternative treatment.

키워드

게실 질환;표준 복강경수술;수보조 복강경수술
Diverticular disease;Standard laparoscopic surgery;Hand-assisted laparoscopic surgery
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