Krebs H B
Am J Obstet Gynecol. 1986 Sep;155(3):509-14. doi: 10.1016/0002-9378(86)90268-1.
From 1973 to 1982, a total of 128 incidents of intestinal injury were recorded in patients undergoing gynecologic operations. Of all lacerations, 37% occurred during entrance into the peritoneal cavity, 35% during lysis of adhesions or performance of pelvic or abdominal dissections, 10% during laparoscopy, 9% during vaginal operations, and 9% during dilatation and curettage and dilatation and evacuation. Injury involved the small intestines in 75% and the large intestines in 25% of the cases. Sixty-nine percent of all lacerations were minor, and 31% were major. Seventy-two percent of the lacerations occurred during uncomplicated gynecologic operations. All lacerations were repaired with one or more of four basic procedures: one- or two-layer closure of intestinal lacerations, partial bowel resection, intestinal reanastomosis, and colostomy. It is suggested that gynecologists acquire basic knowledge in the prevention of intestinal injury and the principles of repair of intestinal lacerations. The role of animal surgical laboratories for the training of residents practicing gynecologic surgery is emphasized.
1973年至1982年期间，接受妇科手术的患者共记录到128例肠道损伤事件。在所有撕裂伤中，37%发生在进入腹腔时，35%发生在粘连松解或盆腔或腹部解剖操作时，10%发生在腹腔镜检查时，9%发生在阴道手术时，9%发生在刮宫术和扩张刮宫术时。75%的病例损伤累及小肠，25%累及大肠。所有撕裂伤中69%为轻度，31%为重度。72%的撕裂伤发生在无并发症的妇科手术期间。所有撕裂伤均采用以下四种基本手术之一或多种进行修复：肠道撕裂伤的一层或两层缝合、部分肠切除、肠吻合术和结肠造口术。建议妇科医生掌握预防肠道损伤的基本知识和肠道撕裂伤的修复原则。强调了动物外科实验室在培训妇科手术住院医师方面的作用。
