腹部手术
1.As long as the abdomen is open you control it.Once closed it controls you.
【译文】腹部敞开着你说了算，关了腹就是它说了算。
【点评】关腹前一切OK，外科医师才能睡得安稳。
2.Dehiscence of the abdominal wound represents a spontaneous decompression of intra-abdominal hypertension.
【译文】腹部伤口哆开意味着腹腔高压的自动减压。
3.Behold, my belly is as wine which hath no vent; it is ready to burst like new bottles.
—— Job.32: 19, The Bible
【译文】你看，我的肚子就像一瓶没排气孔的酒，随时有可能爆裂。
【点评】不要忘了，肚量是有限的，否则怎么会发生“腹腔间室综合征”呢。
4.Abdominal closure: if it looks all right, it's too tight，if it looks too loose,it's all right.
—— Matt Oliver
【译文】关腹：如果看上去刚好，那就太紧，而看上去太松，那就很好。
【点评】关腹时，切口张力是否合适外科医生的直觉常常是很重要的判断标准。“宁松勿紧”，这是所有外科吻合都适用的原则。
5.The gut burst out either because you did not close the tummy properly or it has no place inside.
【译文】肠管膨出要么是肚子没关好，要么是腹腔内空间不够。
6.A "planned hernia" is when you close the abdomen in such a way as to produce an incisional hernia.which you can then repair in a year or so.
【译文】“计划性疝”是指你关腹时特意预留一个切口疝，在手术后一年左右的时间再做修补。
【点评】对腹腔空间不够，有可能发生切口疝的患者可采用这种“计划性疝”的方式主动扩大腹腔空间。
7.Abdominal closure: big continuous bites, with a monofilament and above all, avoiding tension; this is how to avoid dehiscence and herniation.
【译文】关腹：连续大针距缝合、用单股线，最重要的是避免张力过大，这些都是避免伤口哆开和切口疝的措施。
8.You can shit on the peritoneum once and it will forgive you, but not a second time.
【译文】你可虐待腹膜一次，它会原谅你，但不可第二次。(https://www.daowen.com)
9.Better to leave a piece of peritoneum on the bowel than a piece of bowel on the peritoneum.
【译文】在肠子上留下一片腹膜总比在腹膜上留下一块肠子好。
【点评】再次腹部手术时分离粘连的原则。
10.At times it seems as though there is a brain in the suction tip that allows it to find the perfectly appropriate adhesion plane between bowel wall and parietal peritoneum.
—— Timothy Fabian
【译文】有时好像在他的吸引管顶端有一个“大脑”，让它能在肠壁与腹膜的粘连之间找到一个完美、合适的分离平面。
【点评】面对杂乱无章、新旧不一的广泛粘连，真希望在各种钝性或锐性分离器械顶端有一个“智能探头”为分离做指引。
11.To prevent adhesion is to prevent wound healing.
【译文】预防粘连的本质就是阻止伤口的愈合。
【点评】本质上，“粘连”与“愈合”是同一个病理生理过程，目的都是修复创伤，只是前者发生在了错误的地方，后者发生在所需要的地方。所以，译者从来不期望有什么“神药”可减少粘连，减少粘连唯一有效的办法是减少不必要的创伤。
12.Anastomosis: the enemy of good is better; the first layer is the best-why spoil it.
—— Moshe Schein
【译文】关于吻合：好的敌人是更好；一层最好——为什么还要去破坏它呢？
【点评】外科医师经常干弄巧成拙的傻事。
13.Never irrigate over a wider area than has been contaminated.
【译文】（腹腔）冲洗范围应该严格限制于受污染区。
14.To open an abdomen and search for a lesion as lightly as one would open a bureau drawer to look for the laundry, may mean lack of mental overwork to the surgeon, but it means horror to the patient.
—— J.Chalmers Da Costa, 1863——1933
【译文】像打开衣柜抽屉随意找衣物一样打开患者的腹腔寻找病变，对外科医生而言是缺乏认真的术前准备和思考，对患者而言则意味着灾难。
15.Every abdominal surgeon should have a gastric tube passed through his nose for 24 hours.
【译文】每一位腹部外科医师都应该亲自体验一下留置鼻胃管24h的感受。
【点评】严格掌握留置鼻胃管的适应证是消化外科医生一直的追求，也是目前ERAS的基本措施之一。