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.	许峰,马谢民,朱志峰.非计划再手术医疗质量评价指标的研究[J].中国医药科学, 2011, 1(24):17-19.
2.	李晓,刘兵,孟克.我院76例非计划再次手术监测分析与评价[J].中日友好医院学报, 2012, 26(6):369, 371.
3.	华啸,董承刚,韩济南.腹部外伤术后近期再手术38例[J].腹部外科, 2010, 23(4):222-224.
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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.	顾钧,吴文广,丁琦晨,等.胰十二指肠切除术后出血的危险因素及其诊治[J].中国普外基础与临床杂志, 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.	陈鹏.胃癌术后出血的临床研究(附94例病例分析)[D].石家庄:河北医科大学, 2011.
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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,褚忠华,刘璐,等.胃癌根治术后吻合口瘘临床分析[J].岭南现代临床外科, 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.	刘文韬,燕敏.胃癌根治术后吻合口瘘原因及处理[J].中国实用外科杂志, 2013, 33(4):284-286.
17.	陈永安,张辉,叶文彪,等.胃癌术后吻合口瘘的治疗策略探讨[J].中外医疗, 2012, 31(30):60-61.
18.	李文,周建平,王强,等.胃癌D2根治术后胃肠道瘘的再手术治疗体会(附20例报告)[J].中国现代手术学杂志, 2012, 16(6):410-412.
19.	刘福东.术后炎性肠梗阻的治疗[J].中国社区医师:医学专业, 2013, 15(9):109.
20.	刘国正,魏长华,王贵罗.术后早期炎性肠梗阻的诊治体会[J].中国医学创新, 2013, 10(3):118-119.
21.	孙晓光,梁正,马涛,等.术后早期炎性肠梗阻的诊治体会[J].中国现代医学杂志, 2005, 15(24):3777-3778, 3781.
22.	吴刚,孙少珍,吕国先,等.术后早期炎性肠梗阻的诊治体会(附32例报告)[J].现代生物医学进展, 2012, 12(3):508-510.
23.	肖凌晖.术后早期炎性肠梗阻的诊治体会[J].当代医学, 2012, 18(34):91-92.
24.	张勇.26例腹部术后早期炎性肠梗阻的临床分析[J].中国医学工程, 2011, 19(12):96-99.
25.	陈正阳,焦新河.腹部切口裂开原因分析[J].中国医学创新, 2009, 6(15):80-81.
26.	吴涛,黎耀东,李武军,等.腹部切口裂开的原因及围手术期防治[J].陕西医学杂志, 2009, 38(8):1089-1090.
27.	张旗.45例腹部手术切口裂开的原因和防治[J].求医问药:学术版, 2012, 10(8):29-30.

1. 许峰,马谢民,朱志峰.非计划再手术医疗质量评价指标的研究[J].中国医药科学, 2011, 1(24):17-19.
2. 李晓,刘兵,孟克.我院76例非计划再次手术监测分析与评价[J].中日友好医院学报, 2012, 26(6):369, 371.
3. 华啸,董承刚,韩济南.腹部外伤术后近期再手术38例[J].腹部外科, 2010, 23(4):222-224.
4. 朱志峰,毛艾越,赵越.非计划再手术与医疗纠纷关系研究[J].中国医院管理, 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. 顾钧,吴文广,丁琦晨,等.胰十二指肠切除术后出血的危险因素及其诊治[J].中国普外基础与临床杂志, 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. 陈鹏.胃癌术后出血的临床研究(附94例病例分析)[D].石家庄:河北医科大学, 2011.
9. 李承龙.胃癌术后出血的临床分析[D].济南:山东大学, 2012.
10. 邹小明.胃切除术后胃肠道出血的原因与对策[J].中华胃肠外科杂志, 2003, 6(1):12-13.
11. 陈振国,马志敏.消化道肿瘤术后吻合口瘘分析[J].中国社区医师:医学专业, 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,褚忠华,刘璐,等.胃癌根治术后吻合口瘘临床分析[J].岭南现代临床外科, 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. 刘文韬,燕敏.胃癌根治术后吻合口瘘原因及处理[J].中国实用外科杂志, 2013, 33(4):284-286.
17. 陈永安,张辉,叶文彪,等.胃癌术后吻合口瘘的治疗策略探讨[J].中外医疗, 2012, 31(30):60-61.
18. 李文,周建平,王强,等.胃癌D2根治术后胃肠道瘘的再手术治疗体会(附20例报告)[J].中国现代手术学杂志, 2012, 16(6):410-412.
19. 刘福东.术后炎性肠梗阻的治疗[J].中国社区医师:医学专业, 2013, 15(9):109.
20. 刘国正,魏长华,王贵罗.术后早期炎性肠梗阻的诊治体会[J].中国医学创新, 2013, 10(3):118-119.
21. 孙晓光,梁正,马涛,等.术后早期炎性肠梗阻的诊治体会[J].中国现代医学杂志, 2005, 15(24):3777-3778, 3781.
22. 吴刚,孙少珍,吕国先,等.术后早期炎性肠梗阻的诊治体会(附32例报告)[J].现代生物医学进展, 2012, 12(3):508-510.
23. 肖凌晖.术后早期炎性肠梗阻的诊治体会[J].当代医学, 2012, 18(34):91-92.
24. 张勇.26例腹部术后早期炎性肠梗阻的临床分析[J].中国医学工程, 2011, 19(12):96-99.
25. 陈正阳,焦新河.腹部切口裂开原因分析[J].中国医学创新, 2009, 6(15):80-81.
26. 吴涛,黎耀东,李武军,等.腹部切口裂开的原因及围手术期防治[J].陕西医学杂志, 2009, 38(8):1089-1090.
27. 张旗.45例腹部手术切口裂开的原因和防治[J].求医问药:学术版, 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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