双吻合器技术下直肠前切除术后吻合口出血临床分析  

Clinical analysis anastomotic hemorrhage after double-stapling anastomosis in anterior resection for rectal cancer

作　　者：王雁军[1] 肖建安[1] 王青兵[1] Wang Yanjun;Xiao Jian.an;Wang Qingbing(Department of general surgery, The Tumor Hospital of Anyang, Henan 455000, China)

机构地区：[1]安阳市肿瘤医院普外四科,河南455000

出　　处：《中华结直肠疾病电子杂志》2015年第6期641-644,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：目的探讨双吻合器技术下直肠前切除术后吻合口出血的危险因素和处理策略。方法收集2010年01月至2014年12月,455例使用双吻合器行直肠癌前切除术患者的临床资料,对发生吻合口出血病例进行回顾性分析。结果开腹手术303例,腹腔镜142例,共发生吻合口出血10例(2.2%),均为超低位吻合,其中开放手术7例(2.3%),腹腔镜3例(2.1%),静滴止血药物后治疗3例,内镜下钛夹止血4例,肛窥下缝合止血、介入治疗止血、二次手术止血各1例。结论直肠前切除术后吻合口出血可能与吻合平面低有关,该并发症以预防为主,明确吻合口出血后以非手术治疗为主,介入及内镜治疗是有效的止血方法。Objective To explore the risk factors and management strategy of postoperative anastomotic hemorrhage after double-stapling anastomosis in anterior resection for rectal cancer. Methods A total of 455 patients undergoing double-stapling anastomosis in anterior resection for rectal cancer between January 2010 and December 2014 were included in the study. The clinical data were retrospectively reviewed.Results Of the 455 patients, 142 underwent laparoscopic surgery and 303 underwent open surgery.Anastomotic hemorrhage occurred in 10 patients received super-low anastomosis. Of these patients,7 underwent open surgery and 3 underwent laparoscopic surgery. Three cases were treated with intravenous hemostatic agent, 4 with endoscopic titanium clip hemostasis, 1 with suture hemostasis through anoscope,1 with interventional therapy and 1 with reoperation. Conclusions Anastomotic hemorrhage may mainly related to the level of colorectal anastomoses and should be mainly treated with conservative method.Interventional and endoscopic therapies are two effective methods for treating anastomotic hemorrhage.

关 键 词：直肠 外科手术 治疗 

分 类 号：R735.37[医药卫生—肿瘤]