tailieunhanh - Emergencies in Urology - part 6

phẫu thuật chấn thương Reoperative ruột và phẫu thuật ở bệnh nhân chiếu xạ có thể được về mặt kỹ thuật nỗ lực đầy thách thức với các biến chứng tiềm năng, tổn thương đường ruột phổ biến nhất. Dính intraabdominal mở rộng và intrapelvic thường yêu cầu ly giải tẻ nhạt và tỉ mỉ dính trước khi bắt đầu các thủ tục tác chính. | Management of Intraoperative Complications in Open Procedures 319 tion of the complex is difficult secondary to retraction into the deep pelvis and if patient positioning permits pressure applied on the perineal body with a spongestick may pushthe coim lf x into view. When bleeding persists n leree-oaliber urinano vatheten will alarge balloon mat- lw Inarrtea aeh eelated wilh 2h -30 ith of fluid and placed Ob tnmeoeai h traetion. Intestinal Complications _ Bowel lnjury Reoperative surgery and surgery in irradiated patients can be tedmlcaUydiallengmg endeavors fraught w th potential complications intestinal injuries being the most Ineeanbdotmaee and enlrapel-vic adhe-iont afeehnehhlre hehioun ang enrtiaeionv e t sis of adheeévnspriod toiniaéaclon on the nrimaraovert ative procedure. Thisfreqtienda o mane olln-testinal leopa than musd be comalr1eea serteh out. Hie surgeon will findthai nn taiieg dhn naeadnaev timrini-tially to releasradhrsions the eemaìnder aCrhe opnrc-tion shoukijaroceed witOgrecter eate hid leeeopportu-nity for in e e. Oftev Huieth the soagcenwill fmdnhot tissue plane. wíie ptnsenaihemeclvee we-Ta n -e befat tion of bluet aoe rharo diiirc0ioe ee the eitcue in we emphctizetVe aeívcinlo of actively areventinninjoriet ant settine up -De operation for sue ev. Enterotomiae maybe radnncreatec- Tbtnetea poorOy recognizaht When bowct injury is nothd -mmacliate rtt pair is moet pvudea-ihowever a markiag stitch may be placed for Iqter eepaii With small rco-s a timpie ÚT vertiag oe fienre-df-8 sufae man We sufficient. Fer more exteaeive tnil riew v shtcd segmeat oe intestine may be discatUfd withpeimaey WHatt-modei The ails thors prefee aeaee-vewe ecvliniquruting silk suturee ev -wo layets. lajury to the src -ndar tOát bortina of the dnecle-num mayeceur Vveihtaranioal aephnectomnleepct daily oa tha beprevented by adequate aad careful mobiiiaation of .