直肠癌术后直肠阴道瘘的危险因素分析  

Risk factor analysis on rectovaginal fistula after resection in rectal cancer

作　　者：傅骏[1] 郁宝铭[1] 曾悦[2] 吴伟东[2] 张敏[1] 沈英[1] 

机构地区：[1]上海市第八人民医院结直肠外科,上海200035 [2]上海市第一人民医院外科,上海200235

出　　处：《国际外科学杂志》2009年第9期589-591,共3页International Journal of Surgery

摘　　要：目的探讨直肠癌术后直肠阴道瘘的危险因素与临床对策。方法回顾分析1997～2008年1123例女性直肠癌手术患者的临床资料，应用SPSS软件对数据进行统计处理，采用χ^2检验。结果34例（3．03％，34／1123）术后出现直肠阴道瘘。直肠阴道瘘发生与患者有无绝经、肿瘤距肛缘的距离、肿瘤位于直肠壁的部位、吻合方式密切相关（P〈0．05），而与患者年龄、肿瘤T分期、术前放疗、预防性造口等无明显相关。34例患者中12例经保守治疗后自愈，余22例患者均在瘘后3月局部炎症消退后行修补术，在修补直肠阴道瘘的同时行近端肠造口使粪便转流。结论直肠癌术后直肠阴道瘘与患者有无绝经、肿瘤距肛缘的距离、肿瘤位于直肠壁的部位、吻合方式密切相关。熟悉其病因，加强围手术前准备，选择正确的手术时机和手术方式可降低直肠阴道瘘的发生率。Objective To investigate the risk factors on rectovaginal fistula after resection in rectal cancer and clinical strategy. Methods Our retrospective study incXuded 1123 patients of recter cancer who underwent anterior resection with TME technique. Results 3.03% patients （34/1123） developed rectovaginal fistula. Rectovaginal fistulas were raleted with menopausal,location tumor in rectal wall and distance between tumor and anal verge, anastomotic technique, while not with age, T stage, preoperative radiotherapy, diversion stoma construction. Among 34 patients 12 were cured conservatively, fistula repair and colon stoma were performed for the other patients. Conclusions Menopausal, location tumor in rectal wall, distance between tumor and anal verge, anastomotic technique were risk factors for rectovaginal fistula after resection in rectal cancer. Correct choice of surgical procedures, suitable operative timing, enough preoperative preparation are important.

关 键 词：直肠癌 直肠阴道瘘 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]