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采用膨体聚四氟乙烯移植物修复结肠手术后吻合口裂开。

Salvage repair of anastomotic dehiscence following colon surgery using an expanded polytetrafluoroethylene graft.

机构信息

2nd Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

出版信息

Tech Coloproctol. 2012 Apr;16(2):169-73. doi: 10.1007/s10151-010-0638-4. Epub 2010 Aug 6.

Abstract

Anastomotic dehiscence is a serious complication of colorectal surgery that causes death in up to 40% of cases in which it occurs. Edema and inflammation due to abdominal sepsis can prevent the use of standard management (i.e., colostomy, ileostomy or Hartmann's procedure), in which case alternative salvage repair methods are required. The present report describes the treatment of a 73-year-old female patient at high risk of mortality because of intraabdominal sepsis due to suture dehiscence following a right hemicolectomy and ileo-transversostomy. Several surgical repair procedures were tried, but all failed. We then used an expanded polytetrafluoroethylene (ePTFE) graft in salvage repair, and this approach proved successful. This is the first report to describe clinical, macroscopic and histopathological findings, following use of an ePTFE graft in colorectal repair in humans.

摘要

吻合口破裂是结直肠手术的严重并发症,在发生吻合口破裂的病例中,高达 40%的患者因此死亡。由于腹腔感染引起的水肿和炎症,可能会妨碍标准治疗(即结肠造口术、回肠造口术或 Hartmann 手术)的使用,在这种情况下,需要采用其他的挽救性修复方法。本报告介绍了一位 73 岁女性患者的治疗情况,该患者因右半结肠切除术和回肠横结肠吻合术后缝线破裂导致腹腔感染,具有较高的死亡率。我们尝试了多种手术修复方法,但均失败。随后,我们在挽救性修复中使用了膨体聚四氟乙烯(ePTFE)移植物,结果证明该方法是成功的。这是首例在人类结直肠修复中使用 ePTFE 移植物的临床、宏观和组织病理学研究报告。

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