一种可减少系膜广泛重度肥厚克罗恩病术中出血的肠系膜裁剪方法

A method for mesentery division that reduces intraoperative bleeding in severe hypertrophic mesentery within the surgery of Crohn′s disease

在克罗恩病手术中,切除病变肠段时需裁剪、离断病变肠段对应的系膜,但炎性增生导致的系膜重度肥厚可能会使血管难以通过透光和触摸辨认,裁剪系膜时经常损伤血管引起难以控制的出血。即便电脑反馈超级电刀系统Ligasure有闭合大块组织和快速止血的优点,但在处理系膜重度肥厚的克罗恩病系膜时,应用Ligasure常规闭合肥厚系膜依然出血量较大。本文报道一种适用于重度肥厚系膜的肠系膜裁剪方法,其可显著降低术中离断系膜时的出血量。

In Crohn′s disease surgery,excision of the affected intestinal segment necessitates detachment of the corresponding mesentery.However,severe mesenteric hypertrophy due to inflammatory proliferation can impede the identification of blood vessels through transillumination and tactile sensation,often resulting in uncontrollable bleeding during mesenteric division.Additionally,re-closure of the mesenteric wound is prone to recurrent bleeding.Although Ligasure(an advanced bipolar electrosurgical system)offers advantages in grasping and sealing large tissue masses with rapid hemostatic capabilities,conventional use of Ligasure for mesenteric division in cases of severe hypertrophy in Crohn′s disease frequently leads to hemorrhage.Here,we present a novel method for mesenteric division suitable for severe hypertrophy,significantly reducing intraoperative bleeding during mesenteric detachment.