低位直肠癌保肛术无预防性造口的意义  

Avoiding Protective Defunctioning Stoma in Anterior Resection for Low Rectal Cancer

作　　者：崔龙[1] 成世盈[2] 陈卫[1] 姜宏华[1] 徐诘[1] 孟荣贵[3] 戴小江[3] 

机构地区：[1]上海交通大学医学院附属新华医院普外科,上海200092 [2]湖南省人民医院肛肠外科中心,长沙410002 [3]上海长海医院普外科,上海200433

出　　处：《中国现代手术学杂志》2007年第4期266-268,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨低位直肠癌保肛术中不行预防性造口的意义。方法57例低位直肠癌前切除术中,32例未行预防性回肠末端造口（A组）,吻合后行漏气实验以确认缝合严密,并内置肛管,顶端达吻合口上方3～5 cm。25例行预防性造口（B组）。结果A组术后发生吻合口漏1例（3.1%）,吻合口出血2例（6.2%）,切口感染1例（3.1%）,肠梗阻2例（6.2%）;B组发生吻合口漏1例（4.0%）,吻合口出血3例（12.0%）,废用性肠炎19例（76.0%）,切口感染8例（32.0%）,肠梗阻4例（16.0%）。结论应用合适的技术及围手术期处理方法进行无预防性造口的低位直肠癌保肛术效果好,克服了许多预防性造口的并发症。　Objective To evaluate the surgical value of avoiding protective defunctioning ostomy in the low anterior resection for rectal cancer.Methods 32 cases（Group A） were underwent anterior resection without defunctioning ileostomy,and performed air leakage test after anastomosis to confirm the suturation,and were placed the anal canal till to 3～5 cm above the stoma.25 cases（Group B） were received anterior resection and ile ostomy.Results In Group A,the postoperative complications were included by 1 case（3.1%） of anastomotic leakage,2（6.2%） of anastomotic hemorrhage,1（3.1%） of wound infection,and 2（6.2%） of intestinal obstruction.In Group B,the postoperative complications were included by 1 case（4.0%） of anastomotic leakage,3（12.0%） of anastomotic hemorrhage,19（76.0%） of disused enteritis,8（32.0%）of wound infection,and 4（16.0%） of intestinal obstruction.Conclusion The low anterior resection without protective ostomy for rectal cancer is practical and economic.

关 键 词：直肠肿瘤 回肠造口术 保肛术 手术后并发症 

分 类 号：R735.37[医药卫生—肿瘤]