Causes and preventive measures of abdominal wall related complications in laparoscopic rectal cancer surgery
Objective To investigate the causes and preventive measures of abdominal wall related complications in laparoscopic rectal cancer surgery.Methods A retrospective analysis was performed on the clinical data of 215 cases of patients undergoing laparoscopic rectal cancer surgery.All patients underwent laparoscopic Dixon surgery for rectal cancer by traditional 5-port method under general anesthesia.According to the function of surgical incision and the size of puncture holes,the patients were divided into 12 mm primary operating hole(215 holes),12 mm observation hole(215 holes),and 5 mm auxiliary operating hole(645 holes).The occurrence and management of abdominal wall complications were analyzed statistically.The incidence of abdominal wall complications between 12 mm primary operating hole and 12 mm observation hole,12 mm observation hole and 5 mm auxiliary operating hole were compared.Results Among patients undergoing laparoscopic Dixon surgery for rectal cancer,25 holes had abdominal wall-related complications.9 holes with infection,and patients were discharged after patently drainage and dressing change.bleeding was found in 7 holes,in which 5 holes were improved by hemostasis and local compression,and 2 holes were improved by suture hemostasis.There were 5 holes with hernia,in which 3 holes with omentum hernia were improved by suture incision after induction,and 2 holes with intestinal hernia were cured by open surgery.Subcutaneous emphysema was improved in 4 holes after conservative treatment.The incidence of incision infection and hernia in 12 mm observation hole were 0.47%and 0,which were significantly lower than those of 3.72%and 2.33%in 12 mm primary operating hole,and the difference was statistically significant(P<0.05).There was no statistical significance in incidence of bleeding and subcutaneous emphysema between 12 mm primary operating hole and 5 mm auxiliary operating hole(P>0.05).Conclusion The size of Trocar hole and whether to close the fascia of Trocar hole may be the important influencing factors of incision infection and the occurrence of Trocar hernia.Abdominal wall related complications of laparoscopic rectal cancer surgery often occur,clinicians need to strengthen the awareness of prevention,reduce the occurrence of abdominal wall related complications.
Laparoscopic surgeryRectal cancerAbdominal wall related complications
NETL
NSTL
万方数据
维普
