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张廷涛1,张秋雷1,江从庆1,杨贵义2,姜 耕3,宋 辉3,刘侣峰4,艾 旭5,钟 京6,钱 群1
Abstract:
Precaution and treatment of operative complications of perineal proctosigmoidectomy ZHANG Ting-tao*, ZHANG Qiu-lei,JIANG Cong-qing,et al. *Department of Colorectal & Anal Surgery,Zhongnan Hospital,Wuhan University,Wuhan 430071,China. Corresponding author:JIANG Cong-qing,E-mail:wb002554@whu.edu.cn Abstract 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 Altemeier 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-operative details should be paid close attention in order to reduce the intraoperative complications.
Key words: Altemeier procedure , rectal prolapse, complication, precaution
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 mL)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。
关键词: Altemeier手术, 直肠脱垂, 并发症, 预防
张廷涛1,张秋雷1,江从庆1,杨贵义2,姜 耕3,宋 辉3,刘侣峰4,艾 旭5,钟 京6,钱 群1. 经会阴直肠乙状结肠部分切除手术并发症防治(附48例报告)[J]. 中国实用外科杂志, DOI: 10.7504/CJPS.ISSN1005-2208.2016.10.19.
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https://www.zgsyz.com/zgsywk/EN/Y2016/V36/I10/1094