胃癌术后迟发性出血原因分析及处理

Reasons analysis and treatment of the delayed hemorrhage following gastrectomy of gastric cancer

胃癌术后大出血通常发生在术后<24 h,而迟发性出血也是危及病人生命的严重并发症。术后大血管出血、吻合口瘘等多种原因可能引起迟发性出血。随着腹腔镜技术、机器人手术系统以及超声刀、吻合器等新器械越来越广泛地应用,临床上迟发性出血的原因和处理出现了一些新的变化和特征,如较迟发生、反复多次等,更需要预防和积极处理。

The incidence of hemorrhage after radical gastrectomy is at its peak within 24 hours of the procedure. While delayed hemorrhage is still one of the life-threatening complications after surgery. The underlying pathogenesis of delayed hemorrhage could be from major blood vessels damage, anastomotic leakage and so on. Therefore, with more and more new surgical technique and equipment application such as laparoscopic surgery, robotic surgery, ultrasonic scalpel and staple devices, the pathogenesis of delayed hemorrhage and its clinical management have shown some new characteristics and changes, such as late occult and repetitious bleeding. Effective prevention, prompt diagnosis and correct management to the critical event are even more important.