摘要
目的探讨改良Bacon手术的术后常见并发症及其处理。方法选取2012年6月至2017年2月于华中科技大学同济医学院附属同济医院行改良Bacon术39例病人,其中直肠癌23例,肿瘤下缘距齿状线1~3 cm;间质瘤2例,神经内分泌瘤2例,肿瘤下缘距肛缘1~3 cm;腺瘤12例,病变下缘距齿状线0.5~3 cm;分析病人发生的所有并发症。结果盆腔脓肿3例;需手术治疗的连接部狭窄1例;控便功能下降2例;外置肠管坏死3例;外置结肠前壁穿孔2例,上述病人均获痊愈。直肠阴道瘘2例,其中1例造瘘修补后痊愈;1例造瘘,放弃修补手术。1例病人因直肠狭窄自行扩肛意外致直肠穿孔,腹腔感染死亡。结论改良Bacon术很少发生吻合口瘘和盆腔感染,无需预防性造口。对于早期直肠癌及部分良性疾病,可作为一种术式选择。
Objective To summarize the cause and treatment of post-surgical complications after the improved Bacon procedure. Methods Thirty-nine cases undergoing the improved Bacon procedure from June 2012 to February 2017 in Wuhan Tongji Hospital were retrospectively analyzed, including 23 cases of rectal cancer, 2 cases of stromal tumors, 2 cases of neuroendocrine tumor, and 12 cases of adenoma. Results Postoperative complications included pelvic abscess in 3 patients, rectovirginal fistula in 2 patients, one death of abdominal infection after rectal perforation due to self-dilatation accidence, dysdefecation or fecal incontinence in 2 patients, stricture in one patient who needed surgical treatment, perforation in inferior wall of pull-through colon in one patient, and necrosis of the pullthrough colon in 3 patients. Conclusions The improved Bacon procedure is an option for selected patients with early stage rectal cancer and some benign lesions, which offers a low rate of anastomotic leak, pelvic morbidity and use of stoma..
出处
《腹部外科》
2017年第5期381-384,共4页
Journal of Abdominal Surgery
