Internal Hernia Following Robotic Assisted Pancreaticoduodenectomy.
Internal Hernia Following Robotic Assisted Pancreaticoduodenectomy.
复制标题
机器人辅助胰十二指肠切除术后的内疝
DOI：
10.12659/msm.909273
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发表时间：
2018-04-16
期刊：
影响因子：
--
通讯作者：
Peng C
中科院分区：
文献类型：
--
作者：
Qin K;Wu Z;Jin J;Shen B;Peng C
机器人辅助胰腺癌切除术（RPD）是安全可行的。RPD后的内部疝（IH）是一种严重但很少报告的并发症。我们回顾性分析了2010年10月至2016年12月接受RPD的231例患者的数据。研究了发病率、症状、出现时间和结局。5例患者（2.6%）被诊断为IH。IH与横结肠系膜缺损有显著相关性（P<0.001）。在未进行缺损闭合的患者中，IH的发生率为62.5%，而接受缺损闭合的患者未发生IH。初次手术和IH发生之间的中位时间为76天。主要症状为腹痛、恶心、呕吐。所有患者均接受腹部计算机断层扫描（CT），并根据影像学和症状怀疑有IH。所有患者均接受了再次手术（2例腹腔镜手术，3例开放手术）。平均住院时间为13天。治疗后无患者复发。腹痛、恶心和呕吐是我们研究中接受RPD的患者的常见症状。如果CT检查呈阳性，则应怀疑IH。术中出血可引起肠缺血，应及时再次手术。肠系膜缺损的闭合对于避免IH至关重要。
Robotic assisted pancreaticoduodenectomy (RPD) is reported to be safe and feasible. Internal hernia (IH) after RPD is a serious but rarely reported complication. We retrospectively reviewed data of 231 patients who underwent RPD from October 2010 to December 2016. The incidence, symptoms, time of presentation, and outcome were investigated. Five patients (2.6%) were diagnosed with IH. Significant correlation (P<0.001) between IH and transverse mesocolon defect was confirmed. In patients without defect closure, the incidence of IH was 62.5%, while patients who received defect closure experienced no IH. The median time between initial surgery and occurrence of IH was 76 days. The main symptoms were abdominal pain, nausea, and vomiting. All patients received abdominal computed tomography (CT) and were suspected to have IH according to imaging and symptoms. All patients underwent reoperation (2 laparoscopic and 3 open surgery). The median length of hospital stay was 13 days. No patient experienced a relapse after treatment. Abdominal pain, nausea, and vomiting were common symptoms in our study patients who underwent RPD. IH should be suspected if there is a positive finding on CT. Timely reoperation is necessary because IH may cause intestinal ischemia. Meticulous closure of the mesenteric defect is vital to avoid IH.
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影响因子：
9
作者：
Zureikat, Amer H.;Moser, A. James;Zeh, Herbert J., III
通讯作者：
Zeh, Herbert J., III
影响因子：
3.7
作者：
Zeh, Herbert J.;Zureikat, Amer H.;Moser, A. James
通讯作者：
Moser, A. James
影响因子：
2.6
作者：
Buchs, Nicolas Christian;Addeo, Pietro;Giulianotti, Pier Cristoforo
通讯作者：
Giulianotti, Pier Cristoforo
DOI：
10.1007/s00464-015-4140-y
发表时间：
2015-12-01
影响因子：
3.1
作者：
Chen, Shi;Chen, Jiang-Zhi;Li, Hong-Wei
通讯作者：
Li, Hong-Wei
影响因子：
4.3
作者：
Fabozzi, Massimiliano;Contul, Riccardo Brachet;Allieta, Rosaldo
通讯作者：
Allieta, Rosaldo