直肠癌经腹前切除低位吻合术后吻合口漏147例原因分析  

Causes of Anastomotic Leakage after Anterior Resection with Low Anastomosis for Rectal Cancer：Clinical A- nalysis of 147 Cases

作　　者：朱锡元[1] 郭景泉[1] 蒋清平[1] 程涛[1] 卢吉英[1] 

机构地区：[1]浙江省丽水市人民医院肛肠外科/温州医学院附属第六医院,浙江丽水323000

出　　处：《中国肛肠病杂志》2012年第7期19-21,共3页Chinese Journal of Coloproctology

摘　　要：为探讨手术操作预防低位直肠癌Dixon术后吻合口漏的要点，回顾性分析147例低位直肠癌病例行开腹TME手术，以吻合器械完成肠道重建，于吻合口前方及两侧行减张缝合，于骶前吻合口旁常规放置引流管。结果显示，147例低位直肠癌Dixon手术发生吻合口漏8例，6例经二次手术横结肠造口，2例经保守治疗均治愈。结果表明，充分的术前准备，精准的手术操作，确保吻合部位的良好血供、无张力，正确掌握吻合器械的操作，保持术后骶前通畅引流是预防吻合口漏发生的要点。This study was to discuss the preventive measures for anastomotic leakage after Dixon resection for rectal cancer. A retrospective analysis was carried out in 147 cases with low rectal cancer who had undergone laparotomy TME surgery. During the surgical procedure, intestinal reconstruction was completed with stapler for anastomosis,subtracted tension suture was performed in the front and along both sides of the anastomotic stoma,a drainage tube was placed at the presacral anastomotic stoma side by convention. The results showed that of 147 cases,8 occurred anastomotic leakage, 6 underwent secondary transversos- tomy,and 2 got cured by conservative treatment. It is concluded that adequate preoperative preparation and precise surgical performance ensurement that the anastomotic stoma is tension free and has a better blood supply; proper manipulation of stapler,and maintained of presacral unobstructed drainage after surgery are the key points to the prevention of anastomotic leakage.

关 键 词：直肠癌 手术 吻合口漏 

分 类 号：R735.2[医药卫生—肿瘤]