预防性回肠与结肠造口预防吻合口漏的应用对比及预防吻合口漏技术的进展  

The application comparison of defunctioning ileostomy and loop colostomy in the prevention of anastomotic leakage and the development of the technique of preventing anastomotic leakage

作　　者：安柯 李超丰[1] 韩永新 范骁宇 张国超[1] 王文跃[1] An Ke;Li Chaofeng;Han Yongxin;Fan Xiaoyu;Zhang Guochao;Wang Wenyue(Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院普外科,北京100029

出　　处：《中华结直肠疾病电子杂志》2019年第1期67-70,共4页Chinese Journal of Colorectal Diseases(Electronic Edition)

摘　　要：吻合口漏是结直肠术后常见并且严重的并发症之一,预防性回肠及结肠襻式造口被用来应对结直肠术后吻合口漏。每种造口方式都有其优缺点,这篇综述结合当下最新研究结果来探究是否其中一种方式优于另一种。同时对当下预防吻合口漏的策略进行了汇总,主要有经肛肠减压术、盲肠置管造口术、经肛肠腔减压术、管腔内旁路技术、无需回纳预防性造瘘术、带蒂大网膜包裹吻合口术,临床实践中选择何种方式预防吻合口漏需要综合各种情况决定。One of the most severe and common complications after colorectal surgery is anastomotic leakage.Defunctioning loop ileostomy and loop colostomy are used widely to protect/treat anastomotic leakage after colorectal surgery.Each type of defunctioning stoma has its advantages and disadvantages.This review evaluated two types of defunctioning stoma to determine whether one is superior to the other.Meawhile,this review focused on the current methods for preventing anastomotic leakage,strategies were categorised as indwelling rectal tube,transcecal catheter ileostomy,vahrac-secured intracolonic bypass technique,free take-back ileostomy,enclose anastomosis with pedicled omentum.In clinical practice we should comprehensive analyse all kinds of circumstances and choose the best method to prevent anastomotic leakage.

关 键 词：吻合口漏 回肠造口 结肠造口 预防 策略 

分 类 号：R656[医药卫生—外科学]