腹腔镜低位直肠癌前切除术吻合口漏的预防和治疗  

Prevention and treatment of anastomotic leakage after laparoscopic anterior resection of low rectal cancer

作　　者：骆洋[1] 钟鸣[1,2] LUO Yang;ZHONG Ming(Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of General Surgery,Ningbo Hangzhou Bay Hospital,Zhejiang Ningbo 315336,China)

机构地区：[1]上海交通大学医学院附属仁济医院胃肠外科,上海200127 [2]宁波市杭州湾医院普外科,浙江宁波315336

出　　处：《外科理论与实践》2023年第3期220-225,共6页Journal of Surgery Concepts & Practice

摘　　要：吻合口漏是腹腔镜辅助低位直肠癌前切除术后不可避免的严重并发症之一。随着手术技术和认知理念的提高,直肠癌的吻合口越来越低,吻合口漏的问题比较棘手。预防性造口是目前临床上应对吻合口漏的常用方法,但由此带来的过度依赖造口、造口相关并发症等问题也困扰着临床医师。笔者结合多年的实践经验就如何通过吻合口漏风险评估量表避免不必要的造口,以及如何在腹腔镜辅助低位直肠癌前切除术早期发现和处理吻合口漏进行归纳和总结。Anastomotic leakage(AL) is one of the inevitable and severe complications after laparoscopic-assistedanterior resection of low rectal cancer.With the improvement of surgical technology and cognitive concept,the position ofsigmoid-rectal anastomosis is becoming lower and lower,and the problem of AL is more challenging.Preventive stoma iscurrently a common method to deal with AL,but over-reliance on stoma and the stoma-related complications have alsotroubled surgeons.Based on years of practical experience,we summarized how to avoid unnecessary stoma through the riskassessment scale,and how to detect and deal with AL in the early stage of laparoscopic-assisted anterior resection of lowrectal cancer.

关 键 词：腹腔镜 低位直肠癌前切除术 吻合口漏 预防性造口 风险评估量表 

分 类 号：R735.37[医药卫生—肿瘤]