微创外科时代胃手术并发症特点及防治

发布时间：2019-02-14 13:03

【摘要】：近20年来,微创已成为胃外科的发展方向。大量临床数据显示,与开放手术比较,腹腔镜胃手术不但具有美容效果,同时可减少术中失血、减轻腹腔粘连和术后疼痛、加快胃肠功能恢复以及缩短住院时间。腹腔镜胃手术中,术中出血是最常见的并发症,术后迟发性大出血是最危险的并发症,也是造成病人死亡的最主要原因;十二指肠残端漏也是不可忽视的手术并发症,应积极应对;胰瘘发生率虽然明显低于开放手术,但同样须认真对待。3D腹腔镜还原了真实的手术野且增加了放大倍数,故较2D腹腔镜具有更短的学习曲线,术中出血的发生率更低。机器人手术系统是外科手术的革命性成果,裸眼3D高倍图像以及灵活防手颤的机械臂有望进一步减少手术相关并发症发生,从而达到微创、精准的目的。
[Abstract]:In recent 20 years, minimally invasive surgery has become the development direction of gastric surgery. A large number of clinical data show that laparoscopic gastric surgery not only has cosmetic effect, but also can reduce intraoperative blood loss, reduce abdominal adhesion and postoperative pain, accelerate the recovery of gastrointestinal function and shorten the hospitalization time. In laparoscopic gastric surgery, intraoperative bleeding is the most common complication, postoperative delayed hemorrhage is the most dangerous complication, and it is also the main cause of death. Duodenal stump leakage is also a complication that can not be ignored, and should be dealt with actively. Although the incidence of pancreatic fistula is obviously lower than that of open surgery, it should also be taken seriously. 3D laparoscopy reduces the real surgical field and increases the magnification, so it has a shorter learning curve than 2D laparoscopy, and the incidence of intraoperative bleeding is lower. Robot surgery system is a revolutionary result of surgical surgery. 3D high power image of naked eye and flexible arm to prevent hand tremor are expected to further reduce the complications associated with surgery, so as to achieve the goal of minimally invasive and accurate.
【作者单位】：天津医科大学肿瘤医院胃部肿瘤科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室;
【分类号】：R656.61

【相似文献】