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[腹腔镜手术中机械缝合的并发症:吻合钉所致肠梗阻。病例报告及文献综述]

[Complications due to mechanical sutures in laparoscopic surgery: bowel obstruction caused by staple. Case report and literature review].

作者信息

Petrocelli P, Corsale I, Giannessi S, Cerone M, Colugnat D, Matocci G C

机构信息

U.O. Chirurgia Generale, Sezione di Chirurgia Generale, P. O. San Marcello Pistoiese, ASL 3 di Pistoia, Pistoia, Italy.

出版信息

Minerva Chir. 2003 Aug;58(4):591-4.

Abstract

Bowel obstruction after laparoscopic surgical operation is reported only in few cases. The incarceration of bowel loop occurs into the port site more frequently. The case of a young woman, subjected to laparoscopic appendectomy is reported: bowel obstruction occurs on the third postoperative day caused by a staple of the mechanical suture on the caecum, hooked to bowel mesentery. This complication can occur for staples partially formed, spilled in the peritoneum or put to the extremity of mechanical sutures: they can hook to fixed structures and strangle a bowel loop. It may occur in 1.8% of surgical laparoscopic procedures. It can be solved by the simple laparoscopic lysis, above all if an early diagnosis and surgical operation are performed. It is recommendable to remove all the free spilled staples in the peritoneum and close or remove those partially formed to the extremities of the suture.

摘要

腹腔镜手术后发生肠梗阻的病例报道较少。肠袢嵌顿更常发生在穿刺孔部位。本文报道了一名接受腹腔镜阑尾切除术的年轻女性病例:术后第三天发生肠梗阻,原因是盲肠上机械缝合钉钩住肠系膜。这种并发症可能是由于缝合钉部分成型、散落于腹腔或置于机械缝合线末端所致:它们可能钩住固定结构并绞窄肠袢。在1.8%的腹腔镜手术中可能发生。通过简单的腹腔镜松解术即可解决,尤其是在早期诊断并进行手术的情况下。建议清除腹腔内所有散落的游离缝合钉,并封闭或移除那些在缝合线末端部分成型的缝合钉。

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