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STARR手术后腹膜后和直肠系膜血肿一例的腹腔镜手术入路

Laparoscopic approach in a case of retroperitoneal and mesorectal haematoma following STARR procedure.

作者信息

Cerullo Guido, Cassini Diletta, Martellucci Jacopo, Baldazzi Gianandrea

机构信息

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.

出版信息

Int J Surg Case Rep. 2015;6C:237-40. doi: 10.1016/j.ijscr.2014.10.010. Epub 2014 Dec 12.

DOI:10.1016/j.ijscr.2014.10.010
PMID:25553530
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4337917/
Abstract

INTRODUCTION

Stapled transanal rectal resection (STARR) is a widely accepted procedure for treatment of obstructed defecation syndrome.

PRESENTATION OF CASE

We analyzed major bleeding following STARR and exposed our experience regarding its conservative management with particular attention about diagnostic and therapeutic aspects.

DISCUSSION

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.

CONCLUSION

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.

摘要

引言

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。

病例介绍

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。

讨论

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8f/4337917/f36f51433fb2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8f/4337917/9c25bced90ce/gr1v2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8f/4337917/f36f51433fb2/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8f/4337917/9c25bced90ce/gr1v2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8f/4337917/f36f51433fb2/gr3.jpg

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Int J Colorectal Dis. 2008 Oct;23(10):999-1005. doi: 10.1007/s00384-008-0522-0. Epub 2008 Jul 25.
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