Cerullo Guido, Cassini Diletta, Martellucci Jacopo, Baldazzi Gianandrea
General and Mininvasive Surgery - Policlinic of Abano Terme, Italy; Second Unit of General Surgery - "Santa Maria degli Angeli" Hospital of Pordenone, Italy.
General and Mininvasive Surgery - Policlinic of Abano Terme, Italy.
Int J Surg Case Rep. 2015;6C:237-40. doi: 10.1016/j.ijscr.2014.10.010. Epub 2014 Dec 12.
Stapled transanal rectal resection (STARR) is a widely accepted procedure for treatment of obstructed defecation syndrome.
We analyzed major bleeding following STARR and exposed our experience regarding its conservative management with particular attention about diagnostic and therapeutic aspects.
A case by case discussion should be carried out and treatments should be driven by the features and the progression of the haematoma with regards to size, inflammatory signs or severe rectal obstruction.
If a second surgical time and exploration is considered, laparoscopy should be an effective choice while laparotomy, stoma or rectal resection should be considered in those cases with strong suspicious of peritonitis and pelvic abscess.
吻合器经肛门直肠切除术(STARR)是治疗排便梗阻综合征广泛认可的手术方法。
我们分析了STARR术后的大出血情况,并分享了我们对其保守治疗的经验,特别关注诊断和治疗方面。
应逐案进行讨论,并根据血肿的特征和进展情况(如大小、炎症体征或严重直肠梗阻)来决定治疗方案。
如果考虑再次手术和探查,腹腔镜检查应是一种有效的选择;而对于高度怀疑腹膜炎和盆腔脓肿的病例,则应考虑剖腹手术、造口术或直肠切除术。