老年中低位直肠癌吻合口瘘诊治体会  

The cause and prevention of anastomotic leakage after anterior resection for elderly middle-low rectal cancer

作　　者：倪帮高[1] 张跃天[1] 颜磊[1] 刘震[1] 

机构地区：[1]德阳市人民医院普外二科,四川德阳618000

出　　处：《医学信息（中旬刊）》2011年第7期2885-2886,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的:探讨老年中低位直肠癌吻合口瘘的原因及防治经验。方法:对2006～2011年间138例老年中低位直肠癌按TME原则行直肠前切除术的临床资料进行回顾性分析和总结。结果:7例合并多重高危因素的患者术中同时行预防性横结肠造瘘术,术后无吻合口瘘发生;131例未预防造瘘的患者术后发生吻合口瘘14例,10例通过冲洗引流及营养支持保守治愈,3例行横结肠造瘘术,1例行乙状结肠造瘘术,全组无死亡病例。结论:术中对有多重高危因素的老年患者行预防性造瘘是必要的;对老年中低位直肠癌吻合口瘘患者采取个体化原则治疗,大多数可以保守治愈。Objective ： To explore the cause and prevention treatment experience of anastomotic leakage after anterior resection for elderly middle - low rectal cancer. Method：Retrospective analysis the clinical data of 138 old patients underwent anterior resection of rectal cancer according to TME principle from 2006 -2011. Resuits ：7 cases with multiple high- risk factors underwent preventive transverse colon ostomy at the same time, no anastomotic leakage occured;among 131 cases without preventive transverse colon ostomy, anastomotic leakage occured in 14 eases, 10 cases were healed through flushing drainage and nutrition support conservative, There were 3 cases operated transverse colon ostomy and 1 case operated sigmoid colostomy, no death occurred in all cases. Conclusion：h is necessary for the old patients who have multiple high - risk factors to operate preventive colostomy in surgery ; For old patient with middle - low rectal cancer anastomotie leakage, we should adopt the individuation principle treatment, majority may be healed through eonservative treatment.

关 键 词：老年 直肠癌 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]