柱状经腹会阴直肠癌切除术后并发症分析及对策

目的:探讨分析柱状经腹会阴直肠癌切除术术后并发症发生的可能原因,并提出解决对策。方法:回顾分析我院自2010年1月至2014年5月采用柱状经腹会阴直肠癌切除术的68例直肠癌患者的临床资料。记录并分析患者发生术后并发症的情况,探讨发生的可能原因及可行对策。结果:68例患者术后出现并发症共9例,占13.2%。切口并发症4例,术后排尿困难2例,术后骶尾部疼痛3例。结论:柱状经腹会阴直肠癌切除术因为手术切除范围大,术后并发症亦随之凸显。但通过精细的术中解剖、重叠缝合腹膜关闭盆底、骶前通畅引流、合理掌握尿管拔管时机等手段,可有效降低术后并发症的发生。

Study on Postoperative Complications of Cylindrical Abdominoperineal Resection and the Countermeasures

Objective:To explore the possible causes of postoperative complications of cylindrical abdominoperineal resection, and put forward corresponding countermeasures.Methods:68 advanced low-set rectal cancer patients who were given cylindrical abdominoperineal resection admitted in our hospital fromJan 2010 to May 2014 were enrolled in the study. Then the postoperative complications were recorded and analyzed, and the possible reasons and feasible countermeasures were discussed.Results:9 out of 68 cases occurred postoperative complications, accounting for 13.2%. Among the 9 complications, there were 4 cases of incision complication, 2 cases of postoperative dysuria, and 3 cases of sacral tail pain.Conclusion:Due to the wide resection extension, the postoperative complications of cylindrical abdominoperineal resection become prominent. Methods including careful intraoperative dissection, overlapping suturing peritoneumclosure pelvic floor, the former unobstructed drainage and reasonable grasp of the urine tube decannulation time can effectively reduce the occurrence of postoperative complications.