低位直肠癌术后吻合口相关并发症的治疗及改良Bacon术再保肛的要点  

The treatment of anastomosis-related complications after low rectal cancer surgery and the key points of using modified Bacon procedure for redo sphincter-preserving surgery

作　　者：徐晓佳 王昕 黄平 XU Xiaojia;WANG Xin;HUANG Ping(Department of Anorectal Surgery,Sir Run Run Hospital Nanjing Medical University,Nanjing 211100,China;Department of Colorectal and Anal Surgery,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]南京医科大学附属逸夫医院肛肠外科,江苏南京211100 [2]江苏省人民医院结直肠肛门外科,江苏南京210029

出　　处：《中国普通外科杂志》2024年第4期553-560,共8页China Journal of General Surgery

摘　　要：随着腔镜技术的发展、吻合器的出现及手术理念的提升,直肠癌的手术操作越发精细,保肛率逐年提升,直肠癌的吻合口位置也越来越低,但吻合口相关并发症的发生率却未明显下降。吻合口瘘及吻合口狭窄作为直肠癌保肛术后最严重及常见的并发症之一,一旦出现不仅延长患者的住院时间、增加患者的经济负担、影响患者的生活质量甚至会降低患者的生存率。近年来,国内外不同团队针对吻合口相关并发症展开了广泛深入的研究,但吻合口相关并发症的治疗目前国内尚未有统一的标准。本文结合相关文献对吻合口瘘及吻合口狭窄的定义、影响因素、治疗等作一阐述;同时结合团队经验介绍应用改良Bacon术治疗吻合口瘘、吻合口狭窄为患者实行再保肛手术过程中的要点及难点,以期为临床治疗提供参考。With the development of endoscopic technology,the emergence of staplers,and the improvement of surgical concepts,the surgical operation for rectal cancer has become increasingly sophisticated.The anal preservation rate has increased year by year,and the anastomotic position of rectal cancer has also become lower and lower.However,the incidence of anastomosis-related complications has not decreased significantly.As one of the most severe and common complications following rectal cancer surgery,anastomotic leakage,and anastomotic stenosis not only prolong the patients' hospital stay,increase their economic burden,and affect their quality of life,but may even reduce their survival rates.Numerous scholars have conducted extensive and in-depth research on anastomosis-related complications in recent years.However,there is no unified standard for treating anastomosis-related complications in China.Based on relevant literature,this article elaborates on the issues related to anastomotic leakage and stenosis,including definitions,influencing factors,and treatment.At the same time,it introduces the key points and challenges in adopting the modified Bacon procedure for redo sphincter-preserving surgery in patients with anastomotic leakage and anastomotic stenosis,so as to provide a reference for clinical treatment.

关 键 词：直肠肿瘤 手术后并发症 吻合口瘘 器官保留治疗 再手术 

分 类 号：R735.3[医药卫生—肿瘤]