一种可减少系膜广泛重度肥厚克罗恩病术中出血的肠系膜裁剪方法  

A method for mesentery division that reduces intraoperative bleeding in severe hypertrophic mesentery within the surgery of Crohn′s disease

作　　者：赵鑫哲 赵恒宇 沈树安 汪长健[5] 柯嘉[1,2,3] Zhao Xinzhe;Zhao Hengyu;Shen Shu′an;Wang Changjian;Ke Jia(Department of General Surgery(Intestinal Surgery),the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510000,China;Biomedical Innovation Center,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of Anorectum Surgery,the Second People′s Hospital of Liangshan Yi Autonomous Prefecture,Liangshan 615000,China;Department of Anorectum Surgery,Hangzhou Third People′s Hospital,Hangzhou 310009,China)

机构地区：[1]中山大学附属第六医院普通外科(小肠外科),广州510655 [2]广东省结直肠盆底疾病研究重点实验室,广州510000 [3]广州市黄埔区中六生物医学创新研究院,广州510655 [4]凉山彝族自治州第二人民医院肛肠科,凉山615000 [5]杭州市第三人民医院肛肠科,杭州310009

出　　处：《中华炎性肠病杂志（中英文）》2023年第4期379-381,共3页Chinese Journal of Inflammatory Bowel Diseases

基　　金：国家临床重点专科;国家自然科学基金(81970452);广东省消化系统疾病临床医学研究中心项目(2020B1111170004);中山大学5010计划项目(2019022);爱在延长炎症性肠病基金会青峰科研资助项目(CCCF-QF-2022B71-13)。

摘　　要：在克罗恩病手术中,切除病变肠段时需裁剪、离断病变肠段对应的系膜,但炎性增生导致的系膜重度肥厚可能会使血管难以通过透光和触摸辨认,裁剪系膜时经常损伤血管引起难以控制的出血。即便电脑反馈超级电刀系统Ligasure有闭合大块组织和快速止血的优点,但在处理系膜重度肥厚的克罗恩病系膜时,应用Ligasure常规闭合肥厚系膜依然出血量较大。本文报道一种适用于重度肥厚系膜的肠系膜裁剪方法,其可显著降低术中离断系膜时的出血量。In Crohn′s disease surgery,excision of the affected intestinal segment necessitates detachment of the corresponding mesentery.However,severe mesenteric hypertrophy due to inflammatory proliferation can impede the identification of blood vessels through transillumination and tactile sensation,often resulting in uncontrollable bleeding during mesenteric division.Additionally,re-closure of the mesenteric wound is prone to recurrent bleeding.Although Ligasure(an advanced bipolar electrosurgical system)offers advantages in grasping and sealing large tissue masses with rapid hemostatic capabilities,conventional use of Ligasure for mesenteric division in cases of severe hypertrophy in Crohn′s disease frequently leads to hemorrhage.Here,we present a novel method for mesenteric division suitable for severe hypertrophy,significantly reducing intraoperative bleeding during mesenteric detachment.

关 键 词：克罗恩病 肠系膜 手术 术中出血 

分 类 号：R656.6[医药卫生—外科学]