预防吻合口瘘的研究现状与进展  

Status and progress of the research of preventing anastomosis leakage

作　　者：赵海波[1] 葛步军[2] 黄琦[2] 

机构地区：[1]同济大学附属同济医院,上海200065 [2]同济大学附属同济医院普外科,上海200065

出　　处：《国际外科学杂志》2012年第12期832-836,F0003,共6页International Journal of Surgery

基　　金：青年科学基金项目（No.81100324）

摘　　要：吻合口瘘是低位直肠癌癌前切除术的严重并发症，有着较高的发病率和病死率。近年来，许多方法被用来降低吻合口瘘的发病率，本文查阅了PudMed以及万方数据库，聚焦于预防吻合口瘘的方法及对策，主要有：保护性造口、肓肠置管造口术、经月T肠腔减压术、管腔内旁路技术、无需回纳预防性造瘘术，每种方法各有优劣。截止到目前，传统的保护性造口应用较为广泛，其他方法的优势均缺少高水平实验的证据支持，但是，无需回纳预防性造瘘术可以完全转流粪便，不需二次手术回纳造口，初步显示效果良好，值得进一步研究。Anastomotic leak belongs to the serious complications of low anterior resection with high morbidity and fatality. In recent decades, many strategies aimed at lowering the incidence of anastomotic leakage have been developed. This review focused on the methods for preventing anastomotic leakage through searching PudMed and Wanfang data for all related papers. Strategies were categorised as defunctioning stoma,transcecal catheter ileostomy, indwelling rectal tube, vahrac-secured intracolonic bypass technique, free take-back ileostomy. Every strategy has its own advantages and disadvantages. But to date, except defunctioning stoma, none of the methods has been widely accepted due to the lack of high level evidences. However, free take-back ileostomy can avoid stoma related complication and readmission for closure and its initial effect is good, so deserve to further research.

关 键 词：吻合口瘘 直肠肿瘤 可降解吻合环 肠造口术 手术后并发症 预防 

分 类 号：R735.37[医药卫生—肿瘤]