直肠癌切除术后吻合口狭窄14例分析  

Causes and surgical treatment of anastomotic stenosis after colorectal cancer resection:a report of 14 cases

作　　者：李光焰[1] 张安平[1] 王祥峰[1] 刘宝华[1] LI Guangyan ZHANG Anping WANG Xiangfeng et al.(Department of General Surgery, Re- search Institute of Surgery, Daping Hospital, the Third Military Medical University, Chongqing 400042, Chin)

机构地区：[1]第三军医大学大坪医院野战外科研究所普通外科

出　　处：《临床外科杂志》2016年第10期772-774,共3页Journal of Clinical Surgery

摘　　要：目的分析直肠癌切除术后吻合口狭窄的原因。方法直肠癌切除术后吻合口狭窄患者14例，11例行吻合口狭窄环切开术，1例行尿道探条扩张术2次，1例行经腹直肠吻合口狭窄环切除、回肠造口术，1例肿瘤盆腔复发压迫吻合口，行乙状结肠造口术。结果11例吻合口狭窄环切开术患者术后继续手指扩肛，无直肠吻合口狭窄症状。尿道探条扩张术的患者，术后20天行回肠保护性造口还纳术，能够排出稀便。结论吻合口狭窄原因为保护性回肠造口术、吻合口感染和吻合口漏、肿瘤复发、术后盆腔放疗、吻合技术。手术方法主要是吻合口狭窄环切开术、尿道探条扩张术和经腹直肠吻合口狭窄环切除术。Objective To investigate causes and surgical treatment of anastomotic stenosis after resection of rectal carcinoma. Methods There were 14 cases of postoperative anastomotic stenosis,inclu- ding 11 cases of dissection for anastomotic stenosis ring, 1 case of urethral dilatation, 1 case of transab- dominal resection of anastomotic stenosis ring and ileostomy, and 1 case of sigmoidostomy with anastomotic stoma compressed by carcinoma recurrence in pelvic. Results The 11 cases with stenosis ring dissection received following anal dilatation by fingers and there was no recurrence. The patient with urethral dilata- tion received protective ileal colostomy at the 20th day after surgery, and then was able to defecate loose stool. Conclusion The causes of anastomotic stenosis are protective ileostomy, anastomotic leakage, anas- tomotic infection, tumor recurrence, postoperative pelvic radiotherapy and anastomosis skill. Surgical treat- ments mainly include dissection of anastomotic stenosis ring, urethra dilatation and transabdominal resec- tion of anastomotic stenosis ring.

关 键 词：直肠癌根治术 吻合口狭窄 

分 类 号：R735.37[医药卫生—肿瘤]