Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Harbin, 150001, Heilongjiang Province, PR China.
Surg Today. 2010 Aug;40(8):700-5. doi: 10.1007/s00595-009-4140-4. Epub 2010 Jul 30.
Acute mesenteric ischemia (AMI) is a highly lethal clinical entity associated with high morbidity and mortality. Bowel necrosis often results, usually necessitating bowel resection; however, deciding on the extent of resection is problematic as accurate identification of ischemic bowel that may undergo subsequent infarction is difficult. Therefore, a second-look laparotomy after the first operation is usually recommended. While the second-look procedure is widely accepted, its optimal indications and mode are still controversial, raising questions such as "second-look or not?," "planned relaparotomy or relaparotomy on demand?," and "open or laparoscopic?" In this review we discuss the relevant literature and reassess the role of the second-look operation in the treatment of AMI.
急性肠系膜缺血(AMI)是一种高致死率的临床病症,其发病率和死亡率均较高。通常会导致肠坏死,往往需要进行肠切除术;然而,由于准确识别可能发生后续梗死的缺血肠较为困难,因此决定切除范围存在问题。因此,通常建议在第一次手术后进行二次剖腹手术。虽然二次探查术已被广泛接受,但它的最佳适应证和模式仍存在争议,引发了一些问题,如“是否进行二次探查?”“计划性再次剖腹手术还是按需再次剖腹手术?”以及“开放性手术还是腹腔镜手术?”在本文中,我们讨论了相关文献,并重新评估了二次探查手术在 AMI 治疗中的作用。