超选择动脉栓塞术治疗腹腔镜直肠癌术后吻合口大出血(附3例报告)

Hyper-selective arterial embolization in the treatment of anastomotic hemorrhage after laparoscopic rectal carcinoma(report of 3 cases)

目的评估超选择动脉栓塞术治疗直肠癌术后吻合口大出血的可行性和临床效果。方法手术在局部麻醉下进行,经皮穿刺右侧股动脉,置入5 F动脉鞘,取5 F泰尔茂yashiro导管于肠系膜下动脉造影;对于可疑出血区域于乙状结肠动脉二级分支后换3 F泰尔茂progreat微导管超选至各分支处,作染色剂染色减影对照观察。同法取5 F导管于髂内动脉造影,显示髂内动脉及其分支影像;对于可疑出血区域于髂内动脉二级分支后换3 F超细导管超选至各分支染色密集处;作染色剂染色减影对照观察。发现出血部位后行微弹簧圈栓塞。结果 3例患者手术技术均获成功。术后无再出血患者,均临床痊愈。结论超选择动脉栓塞术治疗直肠癌术后吻合口大出血安全有效,为直肠癌术后吻合口大出血提供了一种治疗选择。

Objective To evaluate the feasibility and clinical effect of hyper -selective arterial embolization in thetreatment of postoperative anastomotic hemorrhage of rectal carcinoma. Methods The surgery was under local anesthesia,percutaneous puncture femoral artery on the right side, placing 5 F arterial sheath, taking 5 F terumo manufacturers yashirocatheter in the inferior mesenteric artery angiography; for suspicious bleeding area, after secondary branches in the sigmoidcolon artery, 3 F terumo manufacturers progreat microcatheter ultra were chosen to branches, it was contrasted andobserved by dyeing agent subtraction angiography.5 F catheter was applied in internal iliac artery angiography like thesame method, the internal iliac artery and its branch image were showed. For the suspected hemorrhage region, 3Fsuperfine ducts were selected to the branches after the secondary branch of the iliac artery. It was contrasted and observedby dyeing agent subtraction angiography. The microcoil embolization was performed after the bleeding site was found.Results All three patients were successful. There were no postoperative hemorrhage patients, all patients were clinicalrecovery. Conclusion Hyper -selective arterial embolization is safe and effective in the treatment of postoperativeanastomotic hemorrhage in rectal cancer, and provides a treatment option for postoperative anastomotic hemorrhage.