直肠癌低位/超低位前切除术中预防吻合口瘘的操作技巧  

Intra-operative Skills for Prevention of Anastomotic Leakage Following Low / Super-low Anterior Resection of Rectal Cancer

作　　者：郑阳春[1] 周海洋[1] 宋博[1] 胡海[1] 易波[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》2015年第5期281-283,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：探讨直肠癌低位/超低位前切除术中预防吻合口瘘的操作技巧。方法：对我院2008年1月至2014年12月期间直肠癌行低位/超低位前切除术后出现吻合口瘘患者的临床资料和术中操作技巧进行分析总结。结果：35例患者术后出现吻合口瘘,吻合口瘘发生率4.26%（35/822）;吻合口瘘发生时间为术后4天～25天（中位8天）。13例（37.1%）患者行肠造瘘手术,22例（62.9%）行局部置管冲洗引流,配合全身营养支持治愈,无死亡病例。结论：注重术中操作技巧,确保肠段的血供和无张力,施行高质量的吻合是预防直肠癌低位/超低位前切除术后吻合口瘘的关键。Objective： To investigate the major surgical skills to prevent anastomotic leakage following low/superlow anterior resection of rectal cancer. Methods： Clinical data and intra-operative surgical manoeuvre of patients with anastomotic leakage after low / super-low rectal resection from January 2008 to December 2014 were retrospectively reviewed and summarized. Results： There were 35 cases（ 35 /822,4. 26%） with anastomotic leakage developed within 4 ～ 25 days（ Median 8 days） after surgery. Thirteen cases（ 37. 1%） were cured by temporary enterostomy,while the other 22 cases（ 62. 9%） received conservative treatments with regional irrigation and drainage,together with nutritional supports. None death occurred in this group. Conclusions： Improvement of surgical skills to make satisfying anastomosis with sufficient blood supply and tensionless construction is the key point for prevention of postoperative leakage in operation.

关 键 词：直肠癌 低位/超低位前切除 手术技巧 吻合口瘘 预防 

分 类 号：R735.37[医药卫生—肿瘤]