腹腔镜下直肠远断端再裸化预防吻合口出血  

Prevention of Anastomotic Haemorrhage by Re-dissecting the Rectal Stump in Laparoscopic Procedure:A Retrospective Study

作　　者：周松[1] 聂凯[1] 陈达丰[1] 张文华[1] 薛小军[1] 陈锦荣 陈宇凡 

机构地区：[1]中国人民解放军第一七五医院(厦门大学附属东南医院)普通外科,福建漳州363000

出　　处：《中国现代手术学杂志》2017年第5期333-336,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨腹腔镜下直肠远断端再裸化预防吻合口出血的作用。方法回顾性分析2014年4月~2016年2月行经肛门结肠-直肠吻合的腹腔镜乙状结肠癌、直肠癌手术77例患者的临床资料,观察其手术时间、再裸化时间、术后吻合口出血发生率等情况。结果所有患者均顺利完成腹腔镜手术,无中转开腹。手术时间平均153.6(115~205)min,其中直肠远断端再裸化所需时间平均2.8(2~5)min,术中出血量平均33.1(5~100)ml。术后肛门恢复排气时间平均45.2(20~72)h。术后无一例出现吻合口出血。结论腹腔镜下直肠远断端再裸化是手术中的一个环节,耗时不多,容易掌握,并且能有效预防术后吻合口出血的发生。Objective To investigate the prevention of anastomotic haemorrhage by re-dissecting the rectal stump in laparoscopic procedure. Methods A total of 77 patients with sigmoid colon cancer/rectal cancer performed laparoscopic surgery with end-to-end anastomosis via anus were collected from April2014 to February 2016. The clinical data including operation duration,re-dissection time and anastomotic haemorrhage were retrospectively analyzed. Results The laparoscopic surgery was successfully performed in all cases without conversion to open surgery. The operation duration was 115 to 205 minutes with an average of 153. 6 minutes,the re-dissection time was 2 to 5 minutes with an average of 2. 8 minutes,the intra-operative blood loss volume was 5 to 100 ml with an average of 33. 1 ml,and the gastrointestinal recovery time was 20 to 72 hours with an average of 45. 2 hours. None was complicated with anastomotic bleeding. Conclusion The technique of laparoscopic re-dissection of rectal stump is simple,handling and effective to prevent postoperative anastomotic bleeding.

关 键 词：腹腔镜检查 吻合口出血 结直肠肿瘤 再裸化 

分 类 号：R735.3[医药卫生—肿瘤]