腹腔镜下乙状结肠憩室炎（图文演示）

20. Conclusions
Sigmoidectomy for diverticulitis is often difficult to perform due to the inflammation of the tissues and the obesity which is often associated with the patient’s condition.
Although the medial approach is rarely used in conventional open sigmoid resection for inflammatory disease, it is used in laparoscopy, as it permits the surgeon to safely perform the procedure while avoiding manipulation of the colon and mesenteries.
Laparoscopic sigmoid resection for diverticulitis is currently considered to be an excellent technique which is beneficial for patients.
Even though it is not yet a “gold standard”, it seems quite evident that this minimally invasive approach will play an increasingly important role in the surgical management of diverticulitis.
The smooth performance of this technique depends on:
- the quality of the equipment;
- perfect knowledge of the operative steps;
- exposure of the operative field;
- the experience of the surgical team.

21. Reference
Adachi Y, Kakisako K, Sato K, Shiraishi N, Miyahara M, Kitano S. Factors influencing bowel function after low anterior resection and sigmoid colectomy. Hepatogastroenterology 2000;47:155-8.

Ayoub SF. Arterial supply to the human rectum. Acta Anat 1978;100:317-27.

Bashankaev B, Wexner SD. New indications for laparoscopic sigmoidectomy. Nature 2009;6:388-90.

Domergue J, et al. La chirurgie laparoscopique : aspects techniques. In : Benchimol D, Domergue J, editors. Chirurgie de la maladie diverticulaire sigmoïdienne. Rueil-Malmaison : Arnette; 2000. p. 119-34.

Forgione A, Leroy J, Cahill RA, Bailey C, Simone M, Mutter D, Marescaux J. Prospective evaluation of functional outcome after laparoscopic sigmoid colectomy. Ann Surg 2009;249:218-24.

Kockerling F, Schneider C, Reymond MA, Scheidbach H, Scheuerlein H, Konradt J et al. Laparoscopic resection of sigmoid diverticulitis. Results of a multicenter study. Laparoscopic Colorectal Surgery Study Group. Surg Endosc 1999;13:567-71.

Kohler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. : Surg Endosc 1999;13:430-6.

Leroy J, Cadière GB. Colectomie gauche par laparoscopie. Encycl Méd Chir (Elsevier, Paris), Techniques chirurgicales – Appareil digestif, 40-572, 1999, 9p.

Sereno Trabaldo S, Anvari M, Leroy J, Marescaux J. Prevalence of internal hernias after laparoscopic colonic surgery. J Gastrointest Surg 2009;13:1107-10.

Shafik A, Mostafa H. Study of the arterial pattern of the rectum and its clinical application. Acta Anat 1996;157:80-6.

Tonelli F, Di Carlo V, Liscia G, Servanti A. . [Diverticular disease of the colon: diagnosis and treatment. Consensus Conference, 5th National Congress of the Italian Society of Academic Surgeons]. Ann Ital Chir 2009;80:3-8.

Wong WD, Wexner SD, Lowry A, Vernava A 3rd, Burnstein M, Denstman F, Fazio V, Kerner B, Moore R, Oliver G, Peters W, Ross T, Senatore P, Simmang C. Practice parameters for the treatment of sigmoid diverticulitis--supporting documentation. The Standards Task Force. The American Society of Colon and Rectal Surgeons. Dis Colon Rectum 2000;43:290-7.