摘要
目的分析经会阴直肠乙状结肠部分切除(Altemeier手术)并发症的预防和处理方法。方法回顾2010—2015年湖北省6家医院(武汉大学中南医院、随州市中心医院、荆州市第二人民医院、武穴市第一人民医院、荆门市第一人民医院、团风县人民医院)48例因直肠全层脱垂接受Altemeier手术的病人资料,分析术中及术后并发症情况。结果术中出血(>100 m L)2例。术中损伤内层肠管1例。术后吻合口出血2例,其中1例保守治疗成功,另1例术后第4天再次手术缝扎止血成功。吻合口后壁部分裂开1例,再次手术缝合修补。术后吻合口狭窄1例,给予多次扩肛后完全缓解。结论 Altemeier手术是一种治疗直肠脱垂的经肛门微创术式,但须严格把握手术适应证和注意术中操作细节以减少并发症的发生。
Objective To analyze the precaution and treatment of operative complications of an Altemeier procedure. Methods A retrospective analysis of 48 cases who received Altemeier surgery due to full-thickness rectal prolapse of 6 hospitals in Hubei province from 2010 to 2015. Results Intraoperative complications are as follow： two cases of bleeding（〉100ml）; one case of intraoperative inner intestinal injury. Early postoperative complications are as follow： two cases of anastomotic bleeding, among which, one case was cured with conservative treatment, and the other one received reoperation of suture hemostasis at the fourth day after first surgery; one case of the rear wall portion dehiscence of anastomotic, which was fixed up by reoperation suture. Long-term complications： one case of anastomotic stenosis, which was complete remission after several anal dilation. Conclusion Ahemeier is a minimally invasive surgical approach through the anus for the treatment of rectal prolapse. The indications for surgery should be strictly controlled and intra-operatlve details should be paid close attention in order to reduce the intraoperative complications.
出处
《中国实用外科杂志》
CSCD
北大核心
2016年第10期1094-1095,1100,共3页
Chinese Journal of Practical Surgery
