直肠癌术中骶前静脉丛大出血防治体会

Experience for the prevention and treatment of hemorrhage of presacral venous plexus in the surgical treatment of rectal carcinoma

目的:总结直肠癌根治术骶前静脉丛大出血预防和术中处理方法。方法:回顾性总结分析16例直肠癌根治术发生骶前静脉丛大出血情况,采用明胶海绵、图钉按压或骨蜡嵌入、纱布绷带填塞等方法压迫止血。结果:经用上述方法止血后均未再出血,效果满意。结论:癌肿浸润、术式估计不足及手术操作不当是造成出血的主要原因。为避免大出血,应在直视下操作,沿骶前筋膜前进行,动作细心轻柔,解剖层次清楚。如果出血时止血困难,采用纱布绷带压迫止血简单有效。

Objective： To smmarize experience for the prevention and treatment of hemorrhage of pressaeral venous plexus （PSVP） in the surgical treatment of rectal carcinoma. Method： Retrospective analysis was made on 16 cases of hemorrhage of presacral venous plexus in the radical treatment of rectal carcinoma. Gelatin, thumbtacks or bone wax or gauze were applied for hemostasis by means of pressure. Results： No bleeding occurred any more following hemostasis with the above methods and the results were satisfactory. Discusion： Hemorrhage in the radical treatment of rectal carcinoma was probably mainly due to cancer invasion, underestimated surgery type or improper operational manipulation. To avoid massive hemorrhage, medical people should perform the operation under direct view and proceed from presaeral fascia. If there occurred ,some difficulty in hemostasis, a simple and easy method was to apply gauze with pressure .