Abstract：
Background: Indications for combined colon surgery together with other procedures include oncologic multivisceral resections and abdominal trauma. It is unclear if combining minimally invasive (MI) colon surgery with unrelated other procedures increases the risk for complications. Patients and Methods: The surgical database from two institutions during a 10-year period was queried for combined colon surgeries together with other interventions. All open cases, combined cases performed for one pathology and MI colectomies together with a minor procedure, were excluded. Results: Median age of the 6 men and 7 women was 64.4 (range 42.7-75.4) years. Colon surgeries included right (5), sigmoid (4) transverse (1) colectomies, rectum resection (1), rectopexy (1), and colostomy reversal (1) with indications of colorectal cancer (5), diverticulitis (3), benign ileocecal mass (1), colonic volvulus (3) and rectal prolapse (1). Second procedures included two splenectomies (sarcoidosis, ITP), paraesophageal hernia repairs (4), right diaphragmatic repairs [eventration (2) and Morgagni type hernia]; cholecystectomies (2), appendectomy (acute appendicitis), duodenal wedge resection (carcinoid), reversal of a gastric bypass (Roux limb stricture) one each. Cases were done laparoscopically (7) and robotic assisted (6). In most cases only 4 trocars were used. Median OR time was 4.3 (range 2.5 to 6.6) hours. No anastomotic breakdown was observed. Conclusions: Combining MI colectomy and other major abdominal surgeries can be safely done and in this series did not increase morbidity or mortality but avoids a second operation. Patient selection seems important and port placement may need to be altered to achieve good exposure for both procedures.
摘要：
背景：联合结肠手术和其他手术的适应症包括肿瘤多脏器切除术和腹部创伤。目前尚不清楚微创（MI）结肠手术与无关的其他手术是否会增加并发症的风险。患者和方法：查询了两个机构在10年期间的手术数据库中的联合结肠手术以及其他干预措施。所有打开的箱子,对一种病理和MI结肠切除术以及较小手术进行的合并病例，被排除在外。结果：6名男性和7名女性的中位年龄为64.4（范围42.7-75.4）岁。结肠手术包括权利（5），乙状结肠(4)横行(1)结肠切除术，直肠切除术（1），直肠切除术（1），和结肠造口术逆转（1）与结肠直肠癌的适应症（5），憩室炎(3),良性回盲部肿块（1），结肠扭转（3）和直肠脱垂（1）。第二次手术包括两次脾切除术（结节病，ITP),食管旁疝修补术(4),右膈修补术[膨出(2)和Morgagni型疝]；胆囊切除术(2)，阑尾切除术（急性阑尾炎），十二指肠楔形切除术（类癌），逆转胃旁路术（Roux肢体狭窄）。病例通过腹腔镜（7）和机器人辅助（6）进行。在大多数情况下,仅使用4个套管针。中位OR时间为4.3(范围为2.5至6.6)小时。没有观察到吻合口破裂。结论：可以安全地进行MI结肠切除术和其他大型腹部手术，并且在该系列中不会增加发病率或死亡率，但会避免第二次手术。患者选择似乎很重要，并且可能需要更改端口位置以实现两种程序的良好暴露。
