腹腔镜低位直肠癌根治术后腹壁坏死性筋膜炎的处理

Management of Necrotizing Fasciitis of Abdominal Wall After Laparoscopic Radical Surgery for Lower Rectal Cancer(Miles)

[目的]讨论腹腔镜低位直肠癌根治术（Miles式）术后出现的腹壁坏死性筋膜炎的易感因素及诊疗经验。[方法]对3例腹腔镜低位直肠癌根治术（Miles式）术后坏死性筋膜炎病例的资料进行回顾性分析。[结果]3例患者均顺利出院,术后住院时间为27~38d,平均为29.5d,无全身感染症状,局部切口行二期缝合。[结论 ]腹腔镜直肠癌根治术后出现的腹壁坏死性筋膜炎诊断缺乏一定经验,易感因素众多,病变特点类似其他部位的坏死性筋膜炎,较早的干预治疗效果相对较好。

[Purpose ] To investigate the predisposing factors and treatment experience of abdominal wall necrotizing fasciitis（NF） after laparoscopie radical surgery for lower rectal cancer （Miles）. [Methods] Clinical data of three lower rectal cancer patients with abdominal wall NF after laparoscopie radical surgery （Miles） were analyzed retrospectively. [Results] All of 3 cases were cured ,postoperative hospitalization time was 27-38 days, averaging 29.5 days ,no systemic infection symptoms was found ,and incisions were secondary sutured. [Conclusion] The diagnosis of NF of abdominal wall after laparoscopic radical surgery for lower rectal cancer is lack of experience,predisposing factors are variety ,and the characteristics of the disease is similar to other parts of the NF,early intervention treatment is more important for better prognosis.