直肠低位前切除术后吻合口瘘的处理与预防(附24例报告)  

Treatment and Prevention of Anastomotic Leakage following Low Anterior Resection of Rectal Cancer:with 24 Cases Report

作　　者：郑阳春[1] 宋博[1] 杨敏[1] 胡海[1] 徐琳[1] 刘超[1] 燕锦[1] 

机构地区：[1]四川省肿瘤医院肠道外科,成都610041

出　　处：《肿瘤预防与治疗》2013年第6期333-335,共3页Journal of Cancer Control And Treatment

基　　金：国家自然科学基金资助课题(NO.81272771)

摘　　要：目的：探讨直肠低位前切除术后吻合口瘘的治疗措施及术中处理细节.方法：对我院2008年1月至2012年12月期间直肠低位前切除术后出现吻合口瘘患者的临床资料进行回顾分析.结果：510例行直肠低位前切除术的患者中,24例术后出现吻合口瘘,吻合口瘘发生率4.7%;吻合口瘘发生于术后4天～25天（中位8天）;该24例患者中,8例（33.3%）行肠造瘘手术,16例（66.7%）行局部置管冲洗引流,配合全身营养支持治愈;无患者死亡.结论：大多数吻合口瘘都可以通过保守治疗痊愈,术中精细操作,确保肠段的血供和无张力吻合是预防直肠低位前切除术后吻合口瘘的关键.Objective： To investigate the treatment measurements and the key surgical skills for prevention of anastomotic leakage following low anterior resection of rectal cancer. Methods： Clinical data of patients with anastomotic leakage after low anterior rectal resection from January 2008 to December 2012 were retrospectively reviewed and summarized. Results： Among 510 cases received low anterior rectal resection, 24 cases （4.7%） developed anastomotic leakage from 4 -25 days （Median 8 days） after surgery. Of the 24 cases, eight cases （33.3%） were cured by temporary enterostomy, while the other 16 cases （66.7%） received conservative treatments with regional irrigation and drainage, together with nu- tritional supports. None death occurred in this group. Conclusion： Most of the cases with anastomotic leakage can be man- aged with conservative treatments. Sufficient blood supply and tensionless anastomosis are the two major points for prevention of postoperative leakage following low anterior resection of rectal cancer.

关 键 词：直肠癌 低位前切除 吻合口瘘 预防 

分 类 号：R735.3[医药卫生—肿瘤]