腹腔镜直肠癌前切除术后吻合口漏的预防及诊疗措施  

Prevention and treatment strategies of anastomotic leakage in laparoscopic low anterior resection in locally advanced rectal cancer

作　　者：李干斌 林国乐 Li Ganbin;Lin Guole(Department of General Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院基本外科,北京100730

出　　处：《中华胃肠外科杂志》2025年第1期90-94,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：中央高水平医院临床科研专项(2022-PUMCH-05)。

摘　　要：吻合口漏是腹腔镜直肠癌手术后较为常见且影响患者术后恢复的并发症之一,特别是在“规范化、流程化的新辅助治疗模式全面推广”及“超低位直肠癌保肛技术和理念逐渐成为可能”的两大背景下,如何降低或预防吻合口漏至关重要。张力和血供是保证吻合成功的关键因素,在腹腔镜直肠癌手术中,以降低吻合口张力和改善吻合口血供为核心,可在一定程度上预防或降低吻合口漏的发生。本文将重点从直肠癌手术后吻合口漏的危险因素、预防手段以及治疗措施等方面进行阐述。Anastomotic leakage is a common complication in laparoscopic rectal cancer surgery,which can significantly impact patient recovery.This issue becomes even more critical in the context of the widespread application of standardized and procedural neoadjuvant patterns,as well as the increasing feasibility of anal-preserving surgery for ultra-low rectal cancer.Therefore,strategies to reduce or prevent anastomotic leakage are of paramount importance.Anastomotic tension and blood supply are two key factors that contribute to the success of anastomosis.In laparoscopic rectal cancer surgery,minimizing anastomotic tension and optimizing blood supply are essential to preventing or mitigating the occurrence of anastomotic leakage.This article would discuss the risk factors,preventive measures,and treatment approaches for postoperative anastomotic leakage in rectal cancer surgery.

关 键 词：直肠肿瘤 腹腔镜 吻合口漏 危险因素 预防措施 

分 类 号：R735.37[医药卫生—肿瘤]