临床外科杂志 ›› 2023, Vol. 31 ›› Issue (9): 877-880.doi: 10.3969/j.issn.1005-6483.2023.09.022

• 论著 • 上一篇    下一篇

胃癌根治性切除消化道重建术后Petersen疝11例临床分析

  

  1. 618000 四川省德阳市人民医院胃肠外科(张明燃,李俊),输血科(范玥)
  • 收稿日期:2023-01-22 出版日期:2023-09-20 发布日期:2023-09-20
  • 通讯作者: 张明燃,Email:zhangmingran1991@163.com

Clinical characteristics of 11 cases of Petersen hernia after gastrectomy and reconstruction of digestive tract with gastric cancer

  1. Department of Gastrointestinal Surgery,People’s Hospital of Deyang City,No.173 on Taishan North Road,Sichuan,Deyang 618000, China
  • Received:2023-01-22 Online:2023-09-20 Published:2023-09-20

摘要: 目的 总结胃癌胃切除消化道重建术后发生Petersen疝病人的临床特征,探讨petersen疝的诊断及处理方法。方法 2019年1月~2021年12月我院收治的Petersen疝病人11例,所有病人均行急诊手术治疗,分析病人的临床表现、影像学特征、围手术期情况及治疗后随访情况。结果 11例病人手术中有7例经小肠复位后血供恢复未行肠切除,1例术中证实小肠坏死行部分小肠切除术,切除长度为80cm;此8例病人均再次缝合关闭Petersen间隙,术后顺利出院,随访至今均未再出现急性消化道症状或急腹症。3例术中探查证实小肠广泛坏死,其中1例行小肠次全切除术,另2例放弃进一步手术。此3例病人均于术后24小时内死亡。结论 胃癌术后Petersen疝发病急、进展快,预后不良。当急腹症病人疑有该病可能时应尽早进行腹部增强CT并积极早期剖腹探查,以避免肠坏死的发生。

关键词: 胃癌, 胃切除术, 消化道重建, Petersen疝

Abstract: Objective To summarize the clinical characteristics of patients with Petersen’s hernia after gastrectomy and gastrointestinal reconstruction for gastric cancer,to explore the diagnosis and treatment methods of Petersen’s hernia. Methods Eleven patients diagnosed with Petersen’s hernia admitted to our hospital from January 2019 to December 2021 were collected,and all patients underwent emergency surgery.The clinical manifestations,imaging features,perioperative conditions and post-treatment follow-up of these patients were analyzed and summarized. Results Seven of the 11 patients underwent small bowel reduction and blood supply was restored without bowel resection.One case was confirmed with small bowel necrosis and underwent partial small bowel resection with a length of 80cm.All 8 cases were sutured to close the Petersen space again.The patient was discharged smoothly after the operation,and no acute gastrointestinal symptoms or acute abdomen have occurred during the follow-up so far.Intraoperative exploration confirmed extensive necrosis of the small intestine in 3 cases,of which 1 case underwent subtotal small bowel resection,and the other 2 cases gave up further surgery.All three patients died within 24 hours after surgery. Conclusion Petersen’s hernia after gastric cancer surgery has acute onset,rapid progress and poor prognosis.When patients with acute abdomen are suspected of having the disease,enhanced abdominal CT and early laparotomy should be performed as soon as possible to avoid the occurrence of intestinal necrosis.

Key words: gastric cancer, gastrectomy, reconstruction of digestive tract, Petersen’s hernia

[1] 徐伯麒 章帆 彭耀 毛忠琦 童山. 单吻合口胃旁路术作为袖状胃切除术后修正手术的短期疗效分析[J]. 临床外科杂志, 2023, 31(9): 856-859.
[2] 王青峰 陆晶晶 鲁生林 汪源 吴永丰 张明府. 新辅助化疗后行腹腔镜胃癌根治术并发症有关影响因素及预后分析[J]. 临床外科杂志, 2023, 31(9): 860-863.
[3] 李一博 宋炎阳. 胃癌腹腔镜胃远端切除术不同吻合方式对并发症及胃肠功能的影响[J]. 临床外科杂志, 2023, 31(9): 865-868.
[4] 马立东 刘晓蕾 赵飞. 青蒿素通过TLR4/NF-κB信号通路调节胃癌细胞的生长和炎症因子分泌的机制研究[J]. 临床外科杂志, 2023, 31(8): 738-741.
[5] 刘宇 眭超 陶亮 王萌. 胃肠道术后延迟性肠麻痹研究进展[J]. 临床外科杂志, 2023, 31(7): 698-700.
[6] 徐慧 李昊 秦静静 柳涛涛 谢昌奇 张曹. 术前血浆纤维蛋白原与非转移性胃癌病人预后关系的Meta分析[J]. 临床外科杂志, 2023, 31(4): 348-352.
[7] 李斌 杨冬 周常青. 阿帕替尼联合腹腔热灌注及静脉化疗治疗晚期胃癌腹膜转移转化治疗的效果[J]. 临床外科杂志, 2023, 31(3): 256-260.
[8] 刘炯 汪向飞 江斌. 腹腔镜辅助远端胃癌根治术不同Uncut Roux-en-y吻合方式对病人的疗效及对肿瘤标志物和预后的影响[J]. 临床外科杂志, 2023, 31(2): 177-180.
[9] 蒋祈 张鹏 陶凯雄. 美国国立综合癌症网络临床实践指南:胃癌(2022.V2)更新解读[J]. 临床外科杂志, 2023, 31(1): 18-20.
[10] 张再重 林晨 王烈. 联合脏器切除在进展期胃癌治疗中的意义[J]. 临床外科杂志, 2022, 30(9): 813-814.
[11] 黄昌明 林国生 黄泽宁 陆俊. 吲哚菁绿标记荧光示踪技术在腹腔镜胃癌根治术中的应用[J]. 临床外科杂志, 2022, 30(9): 815-818.
[12] 周岩冰. 机器人和4K腹腔镜在胃癌根治术中淋巴结清扫的比较[J]. 临床外科杂志, 2022, 30(9): 819-822.
[13] 蔺金军 刘俊华 慕立峰 黄占有 魏军龙 李永梅. 胃癌手术、介入化疗后存活19年一例[J]. 临床外科杂志, 2022, 30(9): 828-829.
[14] 莫波 王佩 童宜欣 何志军 梁俊 郝志楠. 膜解剖技术在胃癌根治术中应用的效果分析[J]. 临床外科杂志, 2022, 30(9): 835-838.
[15] 薛志有 倪志海 张毅. 胃癌组织中维甲酸相关孤儿受体α、微管相关蛋白轻链3的表达与病人远期预后的关系[J]. 临床外科杂志, 2022, 30(9): 839-843.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!