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[腹部手术中的二次探查]

[Second look in abdominal surgery].

作者信息

Zaniewski M, Urbanek T, Krupowies A, Kazibudzki M, Majewski E, Ziaja K

机构信息

I Katedry i Kliniki Chirurgii Ogólnej i Naczyń Slaskiej Akademii Medycznej w Katowicach.

出版信息

Wiad Lek. 1997;50 Suppl 1 Pt 2:241-6.

PMID:9424881
Abstract

The paper presents authors experience and indications for an elective relaparotomy performed as the second-look laparotomy after primary operation. 12 patients with vascular or surgical diseases were operated on for: abdominal neoplastic tumors (2 patients), elective abdominal aneurysm (2 patients), ruptured abdominal aneurysm (2), abdominal aneurysm ruptured into the inferior caval vein (1), ruptured aneurysm of the iliac artery (1), abdominal aortic coarctation with visceral arteries abnormality (1), thrombosis of the superior mesenteric artery (1) and peritonitis because of intestinal ischaemia and necrosis (2 patients). In all cases an elective relaparotomy was done on the 1st or 2nd postoperative day. 5 patients died, in 4 cases complications found during second look relaparotomy required surgical treatment (2 of this patients died, two other were successfully treated). The authors discuss indications and advantages of elective second-look laparotomy in abdominal surgery according to the anticipated risk factors and patients condition.

摘要

本文介绍了作者在初次手术后进行选择性再次剖腹手术(作为二次探查剖腹手术)的经验及适应证。12例患有血管或外科疾病的患者接受了手术治疗,病因包括:腹部肿瘤(2例)、选择性腹主动脉瘤(2例)、破裂性腹主动脉瘤(2例)、腹主动脉瘤破裂入下腔静脉(1例)、髂动脉瘤破裂(1例)、腹主动脉缩窄伴内脏动脉异常(1例)、肠系膜上动脉血栓形成(1例)以及因肠缺血坏死导致的腹膜炎(2例)。所有病例均在术后第1天或第2天进行了选择性再次剖腹手术。5例患者死亡,4例在二次探查再次剖腹手术中发现的并发症需要手术治疗(其中2例患者死亡,另外2例成功治愈)。作者根据预期风险因素和患者状况讨论了腹部手术中选择性二次探查剖腹手术的适应证及优势。

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