胃癌根治术后30d内非计划再手术26例分析

发布时间：2019-04-16 08:35

【摘要】：目的总结分析胃癌根治术后30 d内非计划再手术原因和预防措施。方法回顾性分析2012年1月至2015年6月复旦大学附属中山医院普外科收治的行胃癌根治术的4587例病人的临床资料,其中术后30 d内非计划再手术病人26例,总结其临床治疗经验。结果胃癌根治术后30 d内非计划再手术26例病人中,腹腔出血11例(42.3%);吻合口相关并发症10例(38.5%),其中吻合口漏6例,吻合口梗阻1例,十二指肠残端漏3例;切口裂开5例(19.2%)。25例(96.2%)病人经再手术治疗后顺利出院,1例(3.8%)吻合口漏病人再手术后因多器官功能衰竭死亡。结论胃癌根治术后非计划再手术的原因主要包括腹腔出血、吻合口漏、吻合口梗阻、十二指肠残端漏以及切口裂开;规范精细的手术操作和合理有效的围手术期支持是减少胃癌根治术后非计划再手术的关键。
[Abstract]:Objective to summarize and analyze the causes and preventive measures of unplanned reoperation within 30 days after radical resection of gastric cancer. Methods from January 2012 to June 2015, the clinical data of 4587 patients undergoing radical resection of gastric cancer in Zhongshan Hospital, Fudan University were retrospectively analyzed. Among them, 26 patients underwent unplanned reoperation within 30 days after operation, and their clinical treatment experiences were summarized. Results among 26 patients with unplanned reoperation within 30 days after radical gastrectomy, 11 (42.3%) had abdominal bleeding. Anastomotic complications were found in 10 cases (38.5%), including anastomotic leakage in 6 cases, anastomotic obstruction in 1 case and duodenal stump leakage in 3 cases. 25 cases (96.2%) were successfully discharged from hospital after reoperation, and 1 case (3.8%) died of multiple organ failure after reoperation. Conclusion the main causes of unplanned reoperation after radical resection of gastric cancer include abdominal bleeding, anastomotic leakage, anastomotic obstruction, duodenal stump leakage and incision dehiscence. It is the key to reduce unplanned reoperation after radical resection of gastric cancer by standardizing fine operation and reasonable and effective peri-operative support.
【作者单位】：复旦大学附属中山医院普外科;
【分类号】：R735.2

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