Jansen M, Schippers E, Schumpelick V
Chirurgische Universitätsklinik und Poliklinik, RWTH Aachen.
Chirurg. 1998 Jun;69(6):667-8. doi: 10.1007/s001040050473.
Necrotizing fasciitis is a rare and potentially fatal infection of the fascia and subcutaneous tissue. We found only few reports about this disease following laparoscopic surgery. A contamination of the abdominal wall at the trocar position with pathogenic aerobic and anaerobic microorganisms in an "aerosol" is discussed. An increased incidence is associated with risk factors which lead to compromised tissue perfusion and immunosuppression. Early recognition and aggressive surgical management combined with intravenous antibiotics are crucial to a successful outcome. Various aspects of the pathophysiology, diagnosis and therapy of this severe complication following laparoscopic cholecystectomy are discusses.
坏死性筋膜炎是一种罕见的、可能致命的筋膜和皮下组织感染。我们仅发现少量关于腹腔镜手术后发生这种疾病的报告。有人讨论了在“气溶胶”状态下，腹腔穿刺部位的腹壁被致病性需氧菌和厌氧菌污染的情况。发病率的增加与导致组织灌注受损和免疫抑制的危险因素相关。早期识别、积极的手术处理以及静脉使用抗生素相结合对于取得成功的治疗结果至关重要。本文讨论了腹腔镜胆囊切除术后这种严重并发症在病理生理学、诊断和治疗方面的各个问题。
