消化管悪性腫よう術後合併症の救急処置　　胃癌術後縫合不全に伴う重症合併症に対する治療とその成績

• 廣瀬 和郎

  福井医科大学第一外科

• 佐藤 嘉紀

  福井医科大学第一外科

• 村上 真

  福井医科大学第一外科

• 廣野 靖夫

  福井医科大学第一外科

• 前田 浩幸

  福井医科大学第一外科

• 五井 孝憲

  福井医科大学第一外科

• 石田 誠

  福井医科大学第一外科

• 片山 寛次

  福井医科大学第一外科

• 山口 明夫

  福井医科大学第一外科

書誌事項

タイトル別名

• Treatment and Results of Serious Complications Following Anastomotic Leakage after Gastrectomy for Gastric Cancer

抄録

Anastomotic leakage occurred in 66 (9.1%) out of 724 patients who underwent gastrectomy for gastric cancer, 13 of these patients (19%) developed serious complications, including organ failure and/or massive intracorporeal bleeding. All the patients with serious complications had undergone a total gastrectomy, and most of them had stage III or IV tumors, had undergone D2-D3 lymph node dissection, and had received a combined resection of the pancreas or spleen or a curative resection. Of these 13 patients, five suffered massive intracorporeal bleeding and were successfully treated and cured by early surgical drainage and emergent hemostatic procedures, including surgical ligature or transarterial embolization (TAE) using interventional radiology. Two of the patients developed bleeding again and required retreatment using TAE and surgical drainage. The other eight patients suffered organ failure (5, respiratory; 1, renal; and 2, multiple organs). Six of these patients were cured by surgical drainage and adequate therapy for the specific organ failure, such as mechanical ventilation or renal dialysis. However, the other two patients who had a high operative risk and stage III or IV tumors died in hospital of multiple organ failure from the sepsis of a herpes zoster infection or grave aspiration pneumonia. The present results suggested that most patients with serious complications following anastomotic leakage can be cured by prompt and adequate treatment. However, to prevent the complications, safe and adequate operations should be performed based on a precise assessment of the tumor stage and the patient's preoperative condition.

収録刊行物

• 日本腹部救急医学会雑誌

  日本腹部救急医学会雑誌 23 (5), 741-748, 2003

  日本腹部救急医学会

キーワード

• 縫合不全
• 臓器不全

詳細情報

• CRID: 1390282679711614080
• NII論文ID: 130004243234
• DOI: 10.11231/jaem1993.23.741
• ISSN: 18824781
• ISSN: 13402242
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可