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目的探讨腹腔镜辅助直肠前切除术后肠梗阻发生的主要危险因素和预防方法。方法分析100例腹腔镜辅助直肠前切除术患者的临床资料,所有病例术前无急性肠梗阻、穿孔或出血等需行急诊手术,无腹腔内广泛转移,无肺、脑或骨转移,无手术危险程度ASA(美国麻醉师协会评分)≥Ⅳ、Ⅴ级。肿瘤下缘距肛缘距离为4~20 cm,平均(8.26±3.3)cm。所有临床资料经SPSS 13.0 for windows软件包处理后用卡方检验进行统计学分析。结果 100例中无中转开腹,其中术后肠梗阻5例(发生率为5%),发生于术后第4-13天。其中3例经保守治疗治愈。结论只要围手术期处置得当,腹腔镜手术不会增加术后肠梗阻的发生率。
Objective To investigate the main risk factors and prevention methods of intestinal obstruction after laparoscopically assisted anterior rectal resection. Methods The clinical data of 100 patients undergoing laparoscopic anterior rectal resection were analyzed. All patients had no acute intestinal obstruction, perforation, or hemorrhage before surgery. They required emergency surgery, no extensive intraperitoneal metastasis, no lung, brain or bone metastases, and no surgery. The degree of risk ASA (Association of American Anesthesiologists) ≥ IV, V. The distance from the lower edge of the tumor to the anal margin was 4-20 cm, with an average of 8.26 +/- 3.3 cm. All clinical data were processed by SPSS 13.0 for windows software package and analyzed by chi-square test. Results There was no conversion to laparotomy in 100 cases. Postoperative ileus occurred in 5 cases (the incidence was 5%) and occurred on the 4th to 13th days after operation. Three of them were cured with conservative treatment. Conclusion Laparoscopic surgery does not increase the incidence of postoperative intestinal obstruction as long as the perioperative period is properly managed.