腹腔镜结直肠手术术后近期再手术的原因及防范措施

目的探讨腹腔镜结直肠手术术后近期再手术的原因及防范措施。方法对17例行腹腔镜结直肠手术术后近期再手术患者的临床资料进行回顾性分析。结果 17例患者经再手术治疗后16例痊愈,其中再手术后发生并发症5例(切口感染2例、腹腔残余脓肿1例、肺动脉栓塞1例,输尿管狭窄1例),均予对症处理后治愈;1例于再次手术后第5天死于肺动脉栓塞。结论充分的术前检查、严格选择适应证、规范手术操作、适时中转开腹以及针对结直肠患者的一些特殊措施是减少腹腔镜结直肠手术术后近期再手术的关键。

Reasons for Reoperation after Laparoscopic Colorectal Surgery and Preventive Measures

Objective To explore the reasons for reoperation after laparoscopic colorectal surgery and preventive measures.Methods Clinical data of 17 patients who underwent reoperation after laparoscopic colorectal surgery were retrospectively analyzed.Results Sixteen of the 17 patients were cured by reoperation.Among them,5 patients had complications after reoperation（2 cases of incisional wound infection,1 case of abdominal residual abscess,1 case of pulmonary artery embolism and 1 case of ureteral stenosis）and were cured by expectant treatment.One patient died of pulmonary artery embolism on the 5th day after reoperation.Conclusion The keys to reduce reoperation of laparoscopic colorectal surgery are perfecting preoperative examination,selecting indications strictly,standardizing operative procedures,performing laparotomy timely and adopting special measures.