直肠癌保肛术后吻合口漏的定义及诊断标准  

Definition and diagnostic after sphincter-preserving criteria of anastomotic leakage surgery for rectal cancer

作　　者：叶颖江[1] 刘凡[1] Ye Yingjiang, Liu Fan(Department of Gastroenterological Surgery, Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment Research, Peking University People＇s Hospital, Beijing 100044, Chin)

机构地区：[1]北京大学人民医院胃肠外科 结直肠癌诊疗研究北京市重点实验室,100044

出　　处：《中华胃肠外科杂志》2018年第4期361-364,共4页Chinese Journal of Gastrointestinal Surgery

基　　金：国家重点研发计划（2017YFC0908304）

摘　　要：直肠癌保肛术后吻合口漏是常见且严重的直肠癌术后并发症。国内外对吻合口漏进行了大量卓有成效的研究．但是由于一直缺少规范化、有影响力的定义和诊断标准，导致文献记录中出现的名称和定义混乱．因此。本文就吻合口漏名称和定义及诊断标准的演变历史做一简要综述。以理清发展脉络，规范术语的使用。目前，国内学术界“漏”和“瘘”广泛混用现象普遍。按照通用的定义和吻合口连续性中断的词意．现国内普通外科界广泛使用的“吻合口瘘”应当改用“吻合口漏”。通用的诊断标准有2004年发布的Clavien-Dindo分级标准和2010年国际直肠癌研究组发布的吻合口漏的定义和症状分级标准．两者互有优缺点。规范和统一地使用直肠癌保肛术后吻合口漏的定义和诊断标准，有助于提高临床安全性。也有利于学术交流。针对我国现状，仍需要大力促进吻合口漏定义和诊断标准规范化推广工作。Anastomotic leakage is a common and severe postoperative complication foollowing sphincterpreserving surgery of rectal cancer. Many useful studies on anastomotic leakage were conducted both in our country and abroad. However, the lack of standardized and influential definition and diagnostic criteria is responsible for confusion in the literature. In this paper, the history of studies on the definition and diagnostic criteria of anastomotic leakage is reviewed, and the name evolution process of anastomotic leakage in domestic and foreign studies is introduced. We briefly describe the current situation of the coexistence of ＂leakage＂ and ＂fistula＂ in China. Based on the general definition and the word meaning of the interruption of anastomotic continuity, using ＂anastomotic leakage＂ instead of ＂anastomotic fistula＂ is necessary. The common diagnostic criteria are the Clavien-Dindo classification in 2004 and the ISREC definition and grading proposed by the International Study Group of Rectal Cancer in 2010. Both criteria have their own advantages and disadvantages. The standardized use of the definition and diagnostic criteria of postoperative anastomotic leakage of rectal cancer will help improve surgical safety assessment and facilitate academic communication. In view of the current situation of China, we still need to promote standardized definition and diagnostic criteria of anastomotic leakage.

关 键 词：直肠肿瘤 吻合口漏 定义 诊断标准 

分 类 号：R735.37[医药卫生—肿瘤]