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[下消化道手术并发症:预防、识别与治疗]

[Intraoperative complications of the lower gastrointestinal tract : Prevention, recognition and therapy].

作者信息

Ritz J-P

机构信息

Klinik für Allgemein- und Viszeralchirurgie, Helios Kliniken Schwerin, Wismarsche Str. 393-397, 19049, Schwerin, Deutschland,

出版信息

Chirurg. 2015 Apr;86(4):319-25. doi: 10.1007/s00104-014-2849-0.

Abstract

Every surgical intervention is associated with the risk of intraoperative complications. These occur in approximately 2-12% of patients but significantly influence the postoperative outcome, overall complication and mortality rates. This article presents the treatment of typical intraoperative complications during surgery of the lower gastrointestinal tract with a focus on the prevention and identification of risk factors. Especially changes in the regular anatomy caused by previous surgery, inflammation, tumors and emergency situations carry the risk of iatrogenic injuries to the bowels, spleen, ureter and blood vessels. These risk factors must be considered when choosing a surgical procedure, a surgical approach or an appropriate surgeon. The early detection of complications with a definitive restoration is the essential step for a successful treatment without long-term sequelae. Every delay in therapy is associated with an increased morbidity and mortality and should be avoided.

摘要

每一次外科手术干预都伴随着术中并发症的风险。这些并发症大约发生在2%至12%的患者中,但会显著影响术后结果、总体并发症和死亡率。本文介绍了下消化道手术中典型术中并发症的治疗方法,重点是预防和识别风险因素。特别是既往手术、炎症、肿瘤和紧急情况导致的正常解剖结构改变,存在肠道、脾脏、输尿管和血管医源性损伤的风险。在选择手术方式、手术入路或合适的外科医生时,必须考虑这些风险因素。早期发现并发症并进行确切修复是成功治疗且无长期后遗症的关键步骤。治疗的每一次延迟都与发病率和死亡率的增加相关,应予以避免。

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