基层医院腹腔镜直肠癌Miles手术并发症的预防和处理

Prevention and treatment of complications in laparoscopic Miles surgery for rectal carcinoma in primary hospital

目的:探讨腹腔镜Miles术中并发症的预防和处理。方法:回顾分析为73例直肠癌患者行腹腔镜Miles手术的主要并发症及处理。结果:发生并发症7例(9.6%),其中输尿管损伤1例,骶前静脉出血1例,肠系膜血管出血2例,肠管损伤1例,阴道后壁损伤1例,后尿道损伤1例。除1例中转开腹外,余6例均在腹腔镜下行修补术,术后恢复良好。结论:具备丰富的开腹手术经验与娴熟的操作技能,正确的手术操作与处理是减少Miles手术主要并发症的有效方法。

Objective：To investigate the prevention and treatment of operative complication in laparoscopic Miles surgery for rectal carcinoma.Methods：The main complications and relevant treatment of laparoscopic Miles surgery for 73 patients with rectal carcinoma were retrospectively analyzed.Results：Seven complications occurred（9.6%）,including 1 case of ureter injury,1 case of anterior sacral veins hemorrhage,2 cases of mesentery vessels hemorrhage,1 case of bowel injury,1 case of posterior wall of vagina injury,and 1 case of posterior urethra injury.Except that 1 case was converted to open surgery,the other 6 cases underwent laparoscopic repair,and recovered well after operation.Conclusions：The effective measures for decreasing the main complications of Miles surgery include mastering affluent laparotomy experience,skilled operation technique,right operative manipulation and treatment.