带蒂结肠浆肌袖套鞘术在预防直肠癌根治术后吻合口漏中的应用体会  

Application of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer

作　　者：胡明高[1] 李向国[1] 郭彪[1] 江燕燕 HU Minggao1, LI Xiangguo1, GUO Biao1, JIANG Yanyan1,2(1. Department of General Surgery, The PLA Navy Anqing Hospital, Ancling, Anhui 246003, P. R. China; 2. School of Physics and Electronic Engineering of Ancling Normal University, Anqing, Anhui 246011, P. R. Chin)

机构地区：[1]中国人民解放军海军安庆医院普通外科,安徽安庆246003 [2]安庆师范大学物理与电气工程学院,安徽安庆246011

出　　处：《中国普外基础与临床杂志》2018年第8期970-974,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨带蒂结肠浆肌袖套鞘术预防直肠癌根治术后吻合口漏的可行性。方法回顾性分析海军安庆医院2017年1月至2017年10月期间收治的11例行直肠癌根治手术(Dixon)+带蒂结肠浆肌袖套鞘术的直肠癌患者的临床资料。结果 11例直肠癌患者中9例行腹腔镜手术,2例行开放手术,均顺利完成手术,手术时间(255.5±51.5)min,术中出血量(80.0±28.3)m L,术后肛门首次排气时间(4.4±2.0)d,术后住院时间(16.0±3.1)d;术后病理分期:T4期5例,T3期2例,T2期2例,T1期2例;清扫淋巴结5~23枚/例,平均12.5枚/例;伴淋巴结转移者7例。术后发生淋巴漏1例,切口感染1例,无吻合口漏及狭窄发生。术后随访3~10个月,平均随访7个月,无局部复发及远处转移。结论带蒂结肠浆肌袖套鞘术对预防直肠癌根治术后吻合口漏有一定作用。Objective To study feasibility of sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer.Method The clinical data of 11 patients with rectal cancer underwent the Dixon plus sheath technique with seromuscular sleeve of pedicled colon from January 2017 to October 2017 in the PLA Navy Anqing Hospital were analyzed.Results All the operations were completed successfully in the 11 patients with rectal cancer,including 9 cases of laparoscopy and 2 cases of laparotomy.The operative time was（255.5±51.5） min,the intraoperative bleeding was（80.0±28.3） m L,the first postoperative anal exhaust time was（4.4±2.0） d,the postoperative hospitalization time was（16.0±3.1） d.For the postoperative pathology,there were 5 cases of T4 stage,2 cases of T3 stage,2 cases of T2 stage,and 2 cases of T1 stage.The number of lymph node dissection was5–23 with an average of 12.5 per case,7 cases with lymph node metastasis.One case of lymphatic leakage and 1 case of incision infection occurred,and no anastomotic leakage and narrow occurred.After 3–10 months of follow-up（average follow-up 7 months）,no local recurrence and distant metastasis were found.Conclusion Sheath technique with seromuscular sleeve of pedicled colon in preventing anastomotic leakage following radical resection of rectal cancer is feasible.

关 键 词：直肠癌 带蒂结肠 浆肌袖 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]