Prevention and therapeutic strategies of major complications after laparoscopic rectal cancer surgery, Chinese experience in the past 30 years

doi:10.3877/cma.j.issn.1674-3946.2021.01.004

Abstract

Abstract:

With the advancement of laparoscopic instruments and the development of surgical techniques, laparoscopic rectal cancer surgery has become the current mainstream operation. Laparoscopic rectal cancer surgery could provide better surgical vision, more refined anatomy, with less injury, and could achieve better clinical outcome both in China and abroad. Accumulated data from large-sample prospective randomized controlled trials (RCT) research eliminated the concept that laparoscopic rectal cancer surgery might result in a poor oncology outcome. However, complications related to laparoscopic rectal cancer surgery are still the challenge in clinical application for some surgeons. Based on domestic and foreign literatures in recent years and combined with the treatment experience of our center, this article clarifies the types of common complications, causes and prevention strategies after laparoscopic rectal cancer surgery, in order to provide reference to reduce the incidence of complications after laparoscopic rectal cancer surgery.

Key words: Rectal neoplasms, Laparoscopes, Postoperative complications, Universal precautions

Guiying Wang, Xuhua Hu, Ning Zhang, Baokun Li, Jianfeng Zhang, Chaoxi Zhou, Guanglin Wang, Feifei Wang. Prevention and therapeutic strategies of major complications after laparoscopic rectal cancer surgery, Chinese experience in the past 30 years[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(01): 14-19.

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References 40

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分级	临床表现	治疗建议
A级	亚临床吻合口漏，也称作影像学吻合口漏，无临床症状	不需特殊治疗
B级	表现为腹痛、发热，脓性或粪渣样引流物自肛门、引流管或阴道流出(直肠阴道瘘)，白细胞及C反应蛋白升高	保守治疗
C级	表现为腹膜炎、脓毒症，及其他B级吻合口漏的临床表现	手术治疗

分级	临床表现	治疗建议
A级	亚临床吻合口漏，也称作影像学吻合口漏，无临床症状	不需特殊治疗
B级	表现为腹痛、发热，脓性或粪渣样引流物自肛门、引流管或阴道流出(直肠阴道瘘)，白细胞及C反应蛋白升高	保守治疗
C级	表现为腹膜炎、脓毒症，及其他B级吻合口漏的临床表现	手术治疗

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