结直肠手术中运用生物性不可吸收补片行腹膜重建的初步探索  

Explorative application for biomaterial un-absorbable dual-mesh of peritoneal reconstruction in colorectal surgery

作　　者：汪晓东[1] 曹霖[1] 曾天芳[1] 李立[1] 

机构地区：[1]四川大学华西医院肛肠外科,成都610041

出　　处：《重庆医学》2009年第3期309-310,314,F0003,共4页Chongqing medicine

摘　　要：目的初步探讨结直肠手术中运用生物性不可吸收补片进行腹膜重建的临床效果。方法回顾性分析2007年2月至2007年11月,四川大学华西医院肛肠外科治疗组接收结直肠手术的患者,纳入并分析其中采用了生物性不可吸收补片行腹膜重建患者的病历资料。结果研究共纳入了71例患者,均顺利运用补片进行腹膜重建术并完成手术。手术时间55～210min,平均114.23min;术中出血10～300mL,平均45.82mL。所有患者中有52例接受新辅助治疗,术后有68例接受辅助治疗。患者术后经肛排气时间(3.51±0.78)d、拔除血浆引流管时间(2.14±1.32)d、拔除尿管时间(3.51±1.56)d,术后住院时间(9.45±6.46)d,随访期间复查肛门指检发现直肠狭窄者6例(8.45%),有异物感者7例(9.86%),出现中远期肠梗阻者1例(1.41%)。结论使用该补片患者的术后康复情况与未使用该补片的常规手术的报道是接近的,而术后并发症则较常规手术报道的少,但使用补片是否会为患者带来更多的好处以及会带来哪些好处,需要进一步的研究来证实。Objective To discuss the clinical performance of peritoneal reconstruction using un absorbable dual-mesh in analcolorectal surgery. Methods To analyze retrospectively the data of the patients undergoing anal colorectal surgery during February 2007 and November 2007,and the patients undergoing further peritoneal reconstruction using un-absorbable dual-mesh were included. Results A total of 71 patients satisfied the inclusion criteria. The mean operative time was 114.23min（range 55-210min） with a mean blood loss of 45.82mL（range 10-300mL）. There were 52 patients received neo adjuvant therapy while 68 patients accepted postoperative adjuvant therapy. And after operation, the patients initiated anal exsufflation at （3. 51 ± 0. 78）d later, the drainage tube and the urethral catheter was pulled out （2.14±1.32）d and （3.51± 1.56）d respectively after surgery, and the postoperative stay of the patients was （9.45 ±6.46）d. During 2- 12 months follow-up, 6 （8.45 % ） patients were found to suffer rectostenosis by digital rectal examination,7（9.86%） patients had foreign body sensation, and there was 1 patients developed ileus during middle and long term follow up. Conclusion Compared with the published reports,the index of postoperative rehabilitation among the patients in this research were nearly the same as the others, but there were fewer postoperative complications occurred in these patients under going mesh-related peritoneal reconstruction. However,further research is needed to confirm whether the un absorbable dual mesh could bring more hope for the patients or not,and to tell the benefits which patients could obtained by receiving this kind of peritoneal reconstruction.

关 键 词：结直肠外科 生物性不可吸收补片 腹膜重建 

分 类 号：R656.9[医药卫生—外科学]