腹腔镜辅助结直肠癌手术并发症的分析

Analysis of Complications of Laparoscopic Assisted Colorectal Cancer Surgery

目的探讨腹腔镜辅助结直肠癌手术出现的并发症,并进一步研究其预防措施。方法回顾分析赤峰市医院2015年1月—2017年4月收治的102例腹腔镜辅助下结直肠癌手术患者的临床资料,总结分析其出现的并发症。结果所有患者未出现围手术期死亡;5例中转开腹,中转开腹率4.90%;术中并发症发生率为5.88%(6/102),其中术中血管损伤出血5例,小肠破裂1例;术后并发症发生率为13.73%(14/102),其中切口感染6例,吻合口瘘4例,肠梗阻2例,肠坏死1例,吻合口出血1例;出现总并发症的发生率为19.61%(20/102)。结论降低腹腔镜辅助结直肠癌手术并发症的出现,关键在于把握好腹腔镜结直肠癌手术指征,充分做好术前评估,熟练掌握腹腔镜手术的操作技巧及明确解剖层次,同时具备处理意外的能力。

Objective To investigate the complications of laparoscopic assisted colorectal cancer surgery and to further study its preventive measures. Methods The clinical data of 102 cases of laparoscopic assisted colorectal cancer surgery in chifeng hospital from January 2015 to April 2017 were analyzed retrospectively, and the complications were analyzed. Results No perioperative death occurred in all patients. 5 cases were converted to open surgery, and the rate of conversion to laparotomy was 4.90%; The incidence of intraoperative complications was 5.88%（6/102）, including 5 cases of vascular injuries and 1 cases of small intestinal rupture; The incidence of postoperative complications was 13.73%（14/102）, including 6 cases of incisional infection, 4 cases of anastomotic stoma fistula, 2 cases of intestinal obstruction, 1 cases of intestinal necrosis, and 1 cases of anastomotic bleeding; The overall complication rate was 19.61%（20/102）. Conclusion To reduce the emergence of laparoscopic assisted node surgery complications of rectal cancer, the key lies in a good grasp of laparoscopic colorectal surgery indications, preoperative evaluation, operation skills of skilled laparoscopic surgery and clear anatomical level, and ability to deal with unexpected.