腹腔镜胃癌根治术后吻合口漏防治研究进展  

Progress in prevention and treatment of anastomotic leakage after laparoscopic radical gastrectomy for gastric cancer

作　　者：王权[1] 夏明杰[1] WANG Quan;XIA Ming-jie(Department of Gastric and Colorectal Surgery,General Surgery Center,the First Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学第一医院普外中心胃结直肠外科,吉林长春130000

出　　处：《中国实用外科杂志》2023年第9期1066-1069,共4页Chinese Journal of Practical Surgery

基　　金：北京市希思科临床肿瘤学研究基金会项目(No.YMSDPU2021-0281);白求恩医学工程与仪器中心项目(No.BQEGCZX2021010)。

摘　　要：吻合口漏是腹腔镜胃癌根治手术后常见并发症之一,吻合口漏的早期诊断与规范治疗对于防止腹部感染加重播散至关重要。大多数无感染症状的吻合口漏通过液体及营养治疗、充分引流、合理抗生素输注等保守治疗措施可以实现愈合。对于保守治疗无效的病例,内镜下夹闭、引流及封堵等新技术的出现为吻合口漏的治疗提供了更多的选择,但内镜治疗应严格把握治疗时机与适应证,避免加重吻合口损伤。如果病人在治疗过程中出现感染加重,应果断选择手术治疗。吻合口漏手术不必追求一期缝合,主要目的是清除感染灶、实现彻底引流并解决病人肠内营养通道建立的问题。Anastomotic leakage is one of the most common complications after laparoscopic radical gastrectomy for gastric cancer.Early diagnosis and standardized management are crucial for preventing abdominal infection aggravating.Most anastomotic leakage without infection symptoms can be healed through conservative management measures including fluid therapy nutritional supplement,multiple drainage,and reasonable antibiotics.The emergence of new technologies such as endoscopic clipping,drainage and occlusion provides more options for the treatment of anastomotic leakage,but endoscopic treatment should strictly grasp the treatment opportunity and indications to avoid aggravating the injury of the anastomotic tract.If the infection aggravates during the process,surgical procedures treatment should be taken in time.The surgery for anastomotic leakage does not need to pursue one-stage suturing.The main objective is to clear the infected,achieve complete drainage,and establish the enteral nutrition pathway.

关 键 词：腹腔镜胃癌根治术 吻合口漏 腹腔感染 手术治疗 

分 类 号：R6[医药卫生—外科学]