Chen Weijie, Lin Guole
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Apr;19(4):383-5.
In recent years, the laparoscopic anterior rectal cancer resection is increasingly applied in clinical practice, however, laparoscopic operations and stapling techniques can bring a series of related complications. The anastomotic bleeding is one of the early complications in laparoscopic anterior rectal cancer resections. If the continuous anastomotic bleeding is not diagnosed or managed in time, it could lead to serious consequences, such as secondary surgery and shock. Therefore, the diagnosis and treatment of anastomotic bleeding is meaningful. This paper investigates the reasons of anastomotic bleeding after laparoscopic anterior resection of rectal cancer, and introduces related preventions and treatments. Conservative treatment can be used first for small or delayed bleeding. As for acute bleeding from low anastomosis, transanal suture hemostasis can be considered. When the bleeding comes from high anastomosis and is massive and active, laparoscopic or open surgery must be performed immediately.
近年来，腹腔镜直肠癌前切除术在临床实践中的应用越来越广泛，然而，腹腔镜手术和吻合技术会带来一系列相关并发症。吻合口出血是腹腔镜直肠癌前切除术中的早期并发症之一。如果持续的吻合口出血未能及时诊断或处理，可能会导致严重后果，如二次手术和休克。因此，吻合口出血的诊断和治疗具有重要意义。本文探讨了腹腔镜直肠癌前切除术后吻合口出血的原因，并介绍了相关的预防和治疗方法。对于少量或延迟性出血，可首先采用保守治疗。对于低位吻合口的急性出血，可考虑经肛门缝合止血。当出血来自高位吻合口且量大且活跃时，必须立即进行腹腔镜或开放手术。
