Roig-Vila José V, García-Armengol Juan, Bruna-Esteban Marcos, Redondo-Cano Carlos, Tornero-Ibáñez Fernando, García-Aguado Roberto
Consorcio Hospital General Universitario de Valencia, España.
Cir Esp. 2009 Oct;86(4):204-12. doi: 10.1016/j.ciresp.2009.02.015. Epub 2009 Jun 21.
Intra-operative positioning in colorectal surgery is very important from three points of view: the proper surgical approach and exposure, adequate anaesthetic requirements with maintenance of the airway, and the potential complications related to the position. In the present study, we analyse the indications, positioning, advantages and disadvantages of each operative position, their potential complications and how to avoid them. These complications can be of a diverse nature, the most common being injuries related to stretching or compression of peripheral nerves, followed by thromboembolic, haemodynamic, and ischaemic or compartmental syndromes related to ischaemia-reperfusion after a long time in the Trendelenburg position. Anaesthetists and surgeons should coordinate and take responsibility for the position of surgical patients.
从三个角度来看，结直肠手术中的术中体位非常重要：合适的手术入路和视野暴露、维持气道通畅的充足麻醉要求以及与体位相关的潜在并发症。在本研究中，我们分析了每个手术体位的适应证、体位、优缺点、潜在并发症以及如何避免这些并发症。这些并发症可能具有多种性质，最常见的是与周围神经拉伸或受压相关的损伤，其次是与长时间处于头低脚高位后的缺血再灌注相关的血栓栓塞、血流动力学、缺血或骨筋膜室综合征。麻醉医生和外科医生应协调并对手术患者的体位负责。
