骶前引流方式对直肠癌低位前切除术后吻合口漏愈合的影响  

Effect of presacral drainage on the coalescence of anastomotic leakage after low anterior resection of rectal cancer

作　　者：吴川清 刘炜圳 陶凯雄[1] 张维康 

机构地区：[1]华中科技大学同济医学院附属协和医院胃肠外科,武汉430022

出　　处：《腹部外科》2017年第5期378-380,411,共4页Journal of Abdominal Surgery

摘　　要：目的比较经会阴和经腹壁两种不同的骶前引流方式对直肠癌低位前切除术后吻合口漏愈合的影响。方法总结2010年1月至2015年12月间45例直肠癌低位前切除术后吻合口漏的临床资料。结果经会阴和经腹壁两种引流方式在病人年龄、性别、是否接受新辅助放化疗、平均手术时间、p TNM分期、术后发生漏的确定时间、初次手术后平均住院时间等方面差异均无统计学意义(P>0.05)。但经会阴引流组的保护性造口率(16.7%)、腹膜炎发生率(8.3%)及再次手术率(16.7%)均明显低于经腹壁引流组(分别为75.8%、39.4%、93.9%,P<0.05)。结论经会阴骶前引流可降低低位直肠吻合口漏的相关并发症,有助于吻合口漏的愈合。Objective To compare the effect of two different presacral drainage methods through perineum or abdominal wall on the healing of anastomotic leakage after low anterior resection of rectal cancer. Methods The clinical data of 45 cases of anastomotic leakage after low anterior resection of rectal cancer were summarize＆ Results There was no significant difference between the two types of drainage in age, sex, neoadjuvant chemoradiotherapy given or not, the average operative time, pTNM staging, the time of postoperative leakage, and the average length of hospital stay after the initial operation （P〉0. 05）. However, the incidence of peritonitis （8. 3%）, the rate of defunc- tioning stoma （16. 7%）, and re-operation rate （16. 7 %） in the perineal drainage group were significantly lower than those in the abdominal wall drainage group （75.8%, 39. 4% and 93. 9% respectively, P〈0. 05 for all）. Conclusions The transperineal presacral drainage could reduce the complications related to lower rectal anastomotic leakage, and it is helpful for the coalescence of anastomotic leakage.

关 键 词：低位前切除 吻合口漏 骶前引流 直肠癌 经会阴引流 

分 类 号：R657.1[医药卫生—外科学]