Kirchhoff Philipp, Clavien Pierre-Alain, Hahnloser Dieter
Department of Visceral and Transplantation Surgery, University Hospital of Zürich, Switzerland.
Patient Saf Surg. 2010 Mar 25;4(1):5. doi: 10.1186/1754-9493-4-5.
Open or laparoscopic colorectal surgery comprises of many different types of procedures for various diseases. Depending upon the operation and modifiable and non-modifiable risk factors the intra- and postoperative morbidity and mortality rate vary. In general, surgical complications can be divided into intraoperative and postoperative complications and usually occur while the patient is still in the hospital.
A literature search (1980-2009) was carried out, using MEDLINE, PubMed and the Cochrane library.
This review provides an overview how to identify and minimize intra- and postoperative complications. The improvement of different treatment strategies and technical inventions in the recent decade has been enormous. This is mainly attributable to the increase in the laparoscopic approach, which is now well accepted for many procedures. Training of the surgeon, hospital volume and learning curves are becoming increasingly more important to maximize patient safety, surgeon expertise and cost effectiveness. In addition, standardization of perioperative care is essential to minimize postoperative complications.
This review summarizes the main perioperative complications of colorectal surgery and influencable and non-influencable risk factors which are important to the general surgeon and the relevant specialist as well. In order to minimize or even avoid complications it is crucial to know these risk factors and strategies to prevent, treat or reduce intra- and postoperative complications.
开放性或腹腔镜结直肠手术包括针对各种疾病的多种不同类型的手术。根据手术方式以及可改变和不可改变的风险因素，手术中和术后的发病率和死亡率各不相同。一般来说，手术并发症可分为术中并发症和术后并发症，通常在患者仍住院期间发生。
利用MEDLINE、PubMed和Cochrane图书馆进行了文献检索（1980 - 2009年）。
本综述概述了如何识别并尽量减少手术中和术后并发症。近十年来，不同治疗策略和技术发明有了巨大进步。这主要归因于腹腔镜手术方法的增加，现在该方法在许多手术中已被广泛接受。外科医生的培训、医院规模和学习曲线对于最大限度提高患者安全性、外科医生专业水平和成本效益变得越来越重要。此外，围手术期护理的标准化对于尽量减少术后并发症至关重要。
本综述总结了结直肠手术主要的围手术期并发症以及对普通外科医生和相关专科医生都很重要的可影响和不可影响的风险因素。为了尽量减少甚至避免并发症，了解这些风险因素以及预防、治疗或减少手术中和术后并发症的策略至关重要。
