Reason, Prevention, and Treatment of Gastrointestinal Unplanned Reoperation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WUBo-yu ,  ZHANGJiang-nan

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China;

Corresponding?author：

ZHANGJiang-nan, Email: zjnss@sina.com

Keywords：

Gastrointestinal tract; Unplanned reoperation; Reason; Prevention and treatment measure

DOI：

10.7507/1007-9424.20140174

Video：

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Objective To investigate the reason, prevention, and treatment measures of gastrointestinal unplanned reoperation. Methods Clinical data of 21 patients who carried out gastrointestinal unplanned reoperation for various reasons from Jun. 2012 to Jun. 2013 in our hospital were retrospectively analyzed. Results Twenty-one of 2 492 patients with gastrointestinal tract surgery carried out gastrointestinal unplanned reoperation, and the incidence of reoperation was 0.8%. The causes of reoperation were intra-abdominal hemorrhage in 10 cases, gastrointestinal fistula in 7 cases, inflammatory intestinal obstruction with peritonitis in 1 case, and incision dehiscence in 3 cases. After undergoing suture hemostasis, colostomy, anastomotic fistula repair, debridement, and suture,20 cases were cured or improved, and 1 case died. The median of hospitalization expense was 76 000 yuan(46 000-116 000 yuan), and the median of hospital stay was 25-day(16-49 days). Conclusions Gastrointestinal unplanned reoperation can cause more serious economic and emotional burden to patients, standardizing surgical procedure and enhancing perioperative monitoring can reduce the incidence of unplanned reoperation. In addition, grasp legitimately the indications of reoperation, implement timely, and effective reoperation can avoid further deterioration of the disease.

Citation： WUBo-yu, ZHANGJiang-nan. Reason, Prevention, and Treatment of Gastrointestinal Unplanned Reoperation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(6): 736-740. doi: 10.7507/1007-9424.20140174 Copy

1.	?許峰,馬謝民,朱志峰.非計劃再手術醫療質量評價指標的研究[J].中國醫藥科學, 2011, 1(24):17-19.
2.	李曉,劉兵,孟克.我院76例非計劃再次手術監測分析與評價[J].中日友好醫院學報, 2012, 26(6):369, 371.
3.	華嘯,董承剛,韓濟南.腹部外傷術后近期再手術38例[J].腹部外科, 2010, 23(4):222-224.
4.	朱志峰,毛艾越,趙越.非計劃再手術與醫療糾紛關系研究[J].中國醫院管理, 2012, 32(11):21-22.
5.	Kao ML, Lin PY, Heish CE, et al.Predictors of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation[J].Int J Surg, 2013, 11(10):1073-1077.
6.	顧鈞,吳文廣,丁琦晨,等.胰十二指腸切除術后出血的危險因素及其診治[J].中國普外基礎與臨床雜志, 2012, 19(6):653-656.
7.	Buttenschoen K, Tsokos M, Schulz F.Laparoscopic cholecystectomy associated lethal hemorrhage[J].JSLS, 2007, 11(1):101-105.
8.	陳鵬.胃癌術后出血的臨床研究(附94例病例分析)[D].石家莊:河北醫科大學, 2011.
9.	李承龍.胃癌術后出血的臨床分析[D].濟南:山東大學, 2012.
10.	鄒小明.胃切除術后胃腸道出血的原因與對策[J].中華胃腸外科雜志, 2003, 6(1):12-13.
11.	陳振國,馬志敏.消化道腫瘤術后吻合口瘺分析[J].中國社區醫師:醫學專業, 2012, 14(4):57.
12.	Holzner PA, Kulemann B, Kuesters S, et al.Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses[J].World J Gastroenterol, 2011, 17(10):1308-1316.
13.	曾育杰,褚忠華,劉璐,等.胃癌根治術后吻合口瘺臨床分析[J].嶺南現代臨床外科, 2010, 10(5):329-331.
14.	Morks AN, Havenga K, Ten Cate Hoedemaker HO, et al.The C-seal:a biofragmentable drain protecting the stapled colorectal anastomosis from leakage[J].J Vis Exp, 2010, 11(45):2223-2226.
15.	Karatepe O, Kurtulus I, Yalcin O, et al.Adrenomedulline improves ischemic left colonic anastomotic healing in an experimental rodent model[J].Clinics (Sao Paulo), 2011, 66(10):1805-1810.
16.	劉文韜,燕敏.胃癌根治術后吻合口瘺原因及處理[J].中國實用外科雜志, 2013, 33(4):284-286.
17.	陳永安,張輝,葉文彪,等.胃癌術后吻合口瘺的治療策略探討[J].中外醫療, 2012, 31(30):60-61.
18.	李文,周建平,王強,等.胃癌D2根治術后胃腸道瘺的再手術治療體會(附20例報告)[J].中國現代手術學雜志, 2012, 16(6):410-412.
19.	劉福東.術后炎性腸梗阻的治療[J].中國社區醫師:醫學專業, 2013, 15(9):109.
20.	劉國正,魏長華,王貴羅.術后早期炎性腸梗阻的診治體會[J].中國醫學創新, 2013, 10(3):118-119.
21.	孫曉光,梁正,馬濤,等.術后早期炎性腸梗阻的診治體會[J].中國現代醫學雜志, 2005, 15(24):3777-3778, 3781.
22.	吳剛,孫少珍,呂國先,等.術后早期炎性腸梗阻的診治體會(附32例報告)[J].現代生物醫學進展, 2012, 12(3):508-510.
23.	肖凌暉.術后早期炎性腸梗阻的診治體會[J].當代醫學, 2012, 18(34):91-92.
24.	張勇.26例腹部術后早期炎性腸梗阻的臨床分析[J].中國醫學工程, 2011, 19(12):96-99.
25.	陳正陽,焦新河.腹部切口裂開原因分析[J].中國醫學創新, 2009, 6(15):80-81.
26.	吳濤,黎耀東,李武軍,等.腹部切口裂開的原因及圍手術期防治[J].陜西醫學雜志, 2009, 38(8):1089-1090.
27.	張旗.45例腹部手術切口裂開的原因和防治[J].求醫問藥:學術版, 2012, 10(8):29-30.

1. ?許峰,馬謝民,朱志峰.非計劃再手術醫療質量評價指標的研究[J].中國醫藥科學, 2011, 1(24):17-19.
2. 李曉,劉兵,孟克.我院76例非計劃再次手術監測分析與評價[J].中日友好醫院學報, 2012, 26(6):369, 371.
3. 華嘯,董承剛,韓濟南.腹部外傷術后近期再手術38例[J].腹部外科, 2010, 23(4):222-224.
4. 朱志峰,毛艾越,趙越.非計劃再手術與醫療糾紛關系研究[J].中國醫院管理, 2012, 32(11):21-22.
5. Kao ML, Lin PY, Heish CE, et al.Predictors of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation[J].Int J Surg, 2013, 11(10):1073-1077.
6. 顧鈞,吳文廣,丁琦晨,等.胰十二指腸切除術后出血的危險因素及其診治[J].中國普外基礎與臨床雜志, 2012, 19(6):653-656.
7. Buttenschoen K, Tsokos M, Schulz F.Laparoscopic cholecystectomy associated lethal hemorrhage[J].JSLS, 2007, 11(1):101-105.
8. 陳鵬.胃癌術后出血的臨床研究(附94例病例分析)[D].石家莊:河北醫科大學, 2011.
9. 李承龍.胃癌術后出血的臨床分析[D].濟南:山東大學, 2012.
10. 鄒小明.胃切除術后胃腸道出血的原因與對策[J].中華胃腸外科雜志, 2003, 6(1):12-13.
11. 陳振國,馬志敏.消化道腫瘤術后吻合口瘺分析[J].中國社區醫師:醫學專業, 2012, 14(4):57.
12. Holzner PA, Kulemann B, Kuesters S, et al.Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses[J].World J Gastroenterol, 2011, 17(10):1308-1316.
13. 曾育杰,褚忠華,劉璐,等.胃癌根治術后吻合口瘺臨床分析[J].嶺南現代臨床外科, 2010, 10(5):329-331.
14. Morks AN, Havenga K, Ten Cate Hoedemaker HO, et al.The C-seal:a biofragmentable drain protecting the stapled colorectal anastomosis from leakage[J].J Vis Exp, 2010, 11(45):2223-2226.
15. Karatepe O, Kurtulus I, Yalcin O, et al.Adrenomedulline improves ischemic left colonic anastomotic healing in an experimental rodent model[J].Clinics (Sao Paulo), 2011, 66(10):1805-1810.
16. 劉文韜,燕敏.胃癌根治術后吻合口瘺原因及處理[J].中國實用外科雜志, 2013, 33(4):284-286.
17. 陳永安,張輝,葉文彪,等.胃癌術后吻合口瘺的治療策略探討[J].中外醫療, 2012, 31(30):60-61.
18. 李文,周建平,王強,等.胃癌D2根治術后胃腸道瘺的再手術治療體會(附20例報告)[J].中國現代手術學雜志, 2012, 16(6):410-412.
19. 劉福東.術后炎性腸梗阻的治療[J].中國社區醫師:醫學專業, 2013, 15(9):109.
20. 劉國正,魏長華,王貴羅.術后早期炎性腸梗阻的診治體會[J].中國醫學創新, 2013, 10(3):118-119.
21. 孫曉光,梁正,馬濤,等.術后早期炎性腸梗阻的診治體會[J].中國現代醫學雜志, 2005, 15(24):3777-3778, 3781.
22. 吳剛,孫少珍,呂國先,等.術后早期炎性腸梗阻的診治體會(附32例報告)[J].現代生物醫學進展, 2012, 12(3):508-510.
23. 肖凌暉.術后早期炎性腸梗阻的診治體會[J].當代醫學, 2012, 18(34):91-92.
24. 張勇.26例腹部術后早期炎性腸梗阻的臨床分析[J].中國醫學工程, 2011, 19(12):96-99.
25. 陳正陽,焦新河.腹部切口裂開原因分析[J].中國醫學創新, 2009, 6(15):80-81.
26. 吳濤,黎耀東,李武軍,等.腹部切口裂開的原因及圍手術期防治[J].陜西醫學雜志, 2009, 38(8):1089-1090.
27. 張旗.45例腹部手術切口裂開的原因和防治[J].求醫問藥:學術版, 2012, 10(8):29-30.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Reason, Prevention, and Treatment of Gastrointestinal Unplanned Reoperation

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