直肠癌前切除术吻合口漏的原因和诊治体会  

Diagnosis and Treatment of Anastomotic Leakage after Anterior Resection of Rectal Carcinoma

作　　者：丁智勇[1] 任翔英[1] 朱锦德[1] 龚伟[1] 

机构地区：[1]浙江省丽水市中心医院,浙江丽水323000

出　　处：《中国肛肠病杂志》2007年第2期24-26,共3页Chinese Journal of Coloproctology

摘　　要：为探讨直肠癌前切除术吻合口漏的原因、预防和治疗，回顾性总结分析61例直肠癌前切除术吻合口漏的发生原因及诊治方法。结果显示，采用综合性措施保守治疗成功50例，再次手术治疗11例，其中行横结肠造口3例，回肠造口7例，Miles术1例。造口愈合时间平均23（9-115）d。61例均痊愈出院。结果表明，通过对可能产生漏的术前一般状况的调整重视术中严密操作，恰当的引流，合理的抗感染，合适的营养支持等综合性措施，可对大部分直肠癌前切除术吻合口漏的防治取得满意效果；可疑漏可通过造影等技术进一步早期确诊，并采取相应措施；对于吻合口漏保守治疗无效的，果断并及时选择合理的造口，可促使吻合口愈合。Anastomotic leakage,in terms of its occurrence,diagnosis and treatment,after anterior resection of rectal carcinoma of 61 cases was analized retrospectively, Of the 61 cases,50 cases were cured with conservative treatment of comprehensive measures,and 11 cases was cured by second operations（ transverse co7 lostomy for 3 cases,ileostomy for 7 cases and Miles operation for 1 case）. The healing period of the anastomosis was 23 days in average（9-115 days）. It is revealed that such measures as preoperative regulation Of general condition,meticulous intraoperative manipulation, proper drainage, rational anti-inflammatic treatmerit and suitable nutrition support,etc may ensure Satisfactory results in most cases;that the suspected anastomotic leakage should be confirmed by radiography earlier diagnosis and treated ; and that rational colostomy is needed when conservative treatment has failed.

关 键 词：直肠肿瘤 吻合术 外科 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]