末段回肠置管造口预防直肠前切除术后吻合口漏(附64例临床报道)  

Ileostomy via indwelling catheter in terminal ileum to prevent anastomotic leakage after anterior resection of the rectum(64 cases reports)

作　　者：欧阳军[1] 赵晓春[1] 李政[1] 冯程[1] 禹正扬[1] 

机构地区：[1]南华大学附一医院肿瘤外科,湖南衡阳421001

出　　处：《中国内镜杂志》2014年第12期1280-1283,共4页China Journal of Endoscopy

基　　金：国家自然科学基金(NO:30901913);湖南省自然科学基金(NO:11JJ9021)

摘　　要：目的探讨末段回肠置管造口预防直肠前切除术后吻合口漏的临床应用价值。方法对64例腹腔镜及开放直肠前切除保肛手术患者,手术进行至结直肠吻合完毕后,经末段回肠置入一球囊气管导管造口,并妥善固定,观察术后肠内容物转流效果及吻合口漏的发生情况。结果全组患者肠内容物转流彻底,无肠梗阻发生,吻合口漏1例,经保守治疗短期内愈合。拔管后无肠漏及腹膜炎发生,术后可早期进食,恢复满意。结论末段回肠置管造口简单实用,能有效防治直肠前切除术后吻合口漏的发生,并可免除二次手术回纳肠管。[ Objective ] To evaluate the clinical value of ileostomy via indwelling catheter in terminal ileum to prevent anastomotic leakage after anterior resection of the rectum. [Methods] 64 cases of patients underwent laparoscopie/open anterior resection of the rectum, a balloon endotracheal tube was placed in the terminal ileum for ileostomy after completion of the terminal eolorectal anastomosis and fixed properly. Then the intestinal transit function and the occurrence rate of anastomotic leakage were observed after operation. [ Results ] All groups of pa- tientsqntestinal transit function was well and no intestinal obstruction was observed. One case of anastomotic leakage occurred with recovery shortly after conservative treatment. No fecal leakage or peritonitis occurred after extubation. The patients could start taking food early after operation and their recovery was satisfying. [ Conclusion ] Ileostomy via indwelling catheter in terminal ileum was simple and practical. It is an effective prevention and treatment for the occurrence of anastomotic leakage after anterior resection of the rectum which could exempt patients from resurgery for repositioning the bowels.

关 键 词：回肠造口 直肠前切除术 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]