Perioperative nursing of laparoscopic intersphincteric resection

Youyan Chen, Zhenjun Li
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Abstract

Objective To explore the effective perioperative nursing method of the treatment of ultralow rectal cancer through laparoscopic intersphincteric resection (ISR).Methods Sixteen patients with ultralow rectal cancer from June 2009 to June 2011 were chosen,and all patients received the laparoscopic ISR and the perioperative nursing,and the nursing effect was observed.Results All patients could actively cooperate with the operation through perioperative nursing,and the cases of death,anastomotic leakage and postoperative bleeding were not found.All patients had the different degree of anal discomfort symptoms including the bulge,fecal urgency,anal burning,endless defecate feeling after the recovery of the anus defecation.The cases of the perianal skin eczema or ulceration were 11 cases,and the clinical features included that the stool was watery and the number of stool was frequency (3-10 times/day) ; the number of stool was gradually reduced and the time of controlling stool was gradually increased through the perioperative nursing,and most patients obtained the satisfactory bowel control 1 years after operation.The assessment of anal sphincter function one year after operation showed that the cases of A,B,C,D grade were respectively 8,4,3,1 cases,and the good rate of function in patients was 93.75%.Conclusions Perioperative nursing is very important for the laparoscopic ISR,and the attention should be paid to the perioperative nursing so as to improve the clinical efficacy. Key words: Nursing;  Laparoscopy;  Intersphincteric resection
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腹腔镜下括约肌间切除术围手术期护理
目的探讨腹腔镜下微创直肠癌括约肌间切除术(ISR)围手术期的有效护理方法。方法选取2009年6月~ 2011年6月收治的16例超低位直肠癌患者,均行腹腔镜下ISR及围手术期护理,观察护理效果。结果通过围手术期护理,所有患者均能积极配合手术,无死亡、吻合口漏、术后出血病例。所有患者在肛门排便恢复后均有不同程度的肛门不适症状,包括肛门肿胀、大便急迫、肛门灼烧、无止境排便感。肛周皮肤湿疹或溃疡11例,临床表现为大便水样,次数多(3 ~ 10次/d);通过围手术期护理,排便次数逐渐减少,控制排便时间逐渐增加,多数患者术后1年获得满意的排便效果。术后1年肛门括约肌功能评估,A、B、C、D级分别为8例、4例、3例、1例,患者功能优良率为93.75%。结论围手术期护理对腹腔镜ISR手术至关重要,应重视围手术期护理,以提高临床疗效。关键词:护理;腹腔镜检查;Intersphincteric切除
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