末端回肠置管造瘘术防治直肠癌同期放化疗后术后吻合口漏  

Application of transcecum tube ileostomy in prevention of anastomotic leakage in patients with rectal cancer received neoadjuvant chemoradiotherapy

作　　者：王伟峰[1] 庄业忠[1] 夏容珊[2] 黄棉生[1] 林佳锐[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院腹部外科,汕头510041 [2]汕头大学医学院第一附属医院胃肠外科

出　　处：《中华普外科手术学杂志（电子版）》2018年第1期43-45,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：汕头市医疗科技计划项目(201388)~~

摘　　要：目的探讨末端回肠置管造瘘术防治直肠癌同期放化疗术后吻合口漏临床效果。方法选取2013年6月至2015年12月收治的中低位局部晚期直肠癌患者16例,均接受术前放化疗,治疗结束后5~8周行直肠癌全直肠系膜切除术(TME),在TME术中行末端回肠置管造瘘术,观察其术后吻合口漏的发生情况及恢复指标。结果本组患者16例,术后发生吻合口漏2例,占12.5%,予生长抑素及保守治疗后吻合口漏愈合。未发生吻合口漏14例,占87.5%,吻合口愈合良好,术后第10~14天出院。结论末端回肠置管造瘘术可有效减少及治疗直肠癌同期放化疗术后吻合口漏,具有安全性和可行性,可在临床推广应用。Objective To investigate the clinical effect of transcecum tube ileostomy in prevention of anastomotic leakage in patients with tectal cancer received neoadjuvant chemoradiotherapy. Methods From Jun 2013 to Dec 2015, 16 patients with locally advanced rectal cancer underwent preoperative chemoradiotherapy in our hospital were retrospectively analyzed. Total mesorectal excision （TME） and transcecum tube ileostomy were performed 5 -8 weeks after chemoradiotherapy. Clinical variables including the incidence of anastomotic fistula and postoperative rehabilitation were observed. Results There were two patients, accounting for 12. 5%, occurred anastomotie fistula. And the anastomotic fistula healed after somatostatin and conservative treatment. 14 patients, accounting for 87.5%, recovered well with the hospitalization of 10 - 14 days. Conclusion Transcecum tube ileostomy is an effective and safe method in prevention of anastomotie leakage in pitients with rectal cancer received neoadjuvant ehemoradiotherapy.

关 键 词：直肠肿瘤 外科手术 化学疗法 辅助 放射疗法 辅助 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]