【摘要】：目的總結(jié)分析胃癌根治術(shù)后30 d內(nèi)非計(jì)劃再手術(shù)原因和預(yù)防措施。方法回顧性分析2012年1月至2015年6月復(fù)旦大學(xué)附屬中山醫(yī)院普外科收治的行胃癌根治術(shù)的4587例病人的臨床資料,其中術(shù)后30 d內(nèi)非計(jì)劃再手術(shù)病人26例,總結(jié)其臨床治療經(jīng)驗(yàn)。結(jié)果胃癌根治術(shù)后30 d內(nèi)非計(jì)劃再手術(shù)26例病人中,腹腔出血11例(42.3%);吻合口相關(guān)并發(fā)癥10例(38.5%),其中吻合口漏6例,吻合口梗阻1例,十二指腸殘端漏3例;切口裂開5例(19.2%)。25例(96.2%)病人經(jīng)再手術(shù)治療后順利出院,1例(3.8%)吻合口漏病人再手術(shù)后因多器官功能衰竭死亡。結(jié)論胃癌根治術(shù)后非計(jì)劃再手術(shù)的原因主要包括腹腔出血、吻合口漏、吻合口梗阻、十二指腸殘端漏以及切口裂開;規(guī)范精細(xì)的手術(shù)操作和合理有效的圍手術(shù)期支持是減少胃癌根治術(shù)后非計(jì)劃再手術(shù)的關(guān)鍵。
[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.
【作者單位】： 復(fù)旦大學(xué)附屬中山醫(yī)院普外科;
【分類號(hào)】：R735.2

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