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严重患者在局部麻醉下采用改良Altemeier法进行造口脱垂手工修复:1例病例报告及文献复习

Stoma prolapse handmade repair under local anesthesia with variation of Altemeier method in severe patients: a case report and review of the literature.

作者信息

Papadopoulos Vasileios, Bangeas Petros, Xanthopoulou Kassandra, Paramythiotis Daniel, Michalopoulos Antonios

机构信息

1st Surgical Propedeutic Department, Medical Faculty, AHEPAUniversity Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

J Surg Case Rep. 2017 Feb 28;2017(2):rjx027. doi: 10.1093/jscr/rjx027. eCollection 2017 Feb.

Abstract

Stoma prolapse represents one of the most common late complications, occurring in 1-16%. Final rate depends on systematic follow up of the patient and the primary technique. A 49-year-old male patient presented in the Emergency Department, complaining about stoma prolapse, pain and stoma care difficulties. On admission, his colostomy protruded ~20 cm from the skin. The symptoms were local pain and psychological stress. The prolapse was repaired successfully with a simple revision procedure under local anesthesia, by resecting the prolapsed part of the bowel and reconstruction of stoma. Prolapsed part of the colon is removed and the remaining end of the colon is fixated to the abdominal wall. Colorectal surgeons must familiarize with management of stoma complications. Stoma revision under local anesthesia is an alternative and safe method.

摘要

造口脱垂是最常见的晚期并发症之一,发生率为1%至16%。最终发生率取决于对患者的系统随访和初始技术。一名49岁男性患者因造口脱垂、疼痛及造口护理困难就诊于急诊科。入院时,他的结肠造口从皮肤处突出约20厘米。症状为局部疼痛和心理压力。在局部麻醉下通过简单的修复手术成功修复了脱垂,手术方式为切除肠管脱垂部分并重建造口。切除脱垂的结肠部分,将剩余的结肠末端固定于腹壁。结直肠外科医生必须熟悉造口并发症的处理。局部麻醉下的造口修复是一种可供选择的安全方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3c4/5400450/6eea9ab7fa88/rjx027f01.jpg

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