直肠癌前切除术后吻合口瘘的防治

目的探讨低位直肠癌保肛术后吻合口瘘的原因和防治措施。方法回顾分析2004年1月～2010年1月该院276例低位直肠癌患者行全直肠系膜切除术的临床资料。结果 276例患者术后发生吻合口瘘26例(10.6%),其中二次手术4例。结论应用管状吻合器技术提高了低位直肠癌保肛率,缩短了手术时间,吻合安全、可靠;发生吻合口瘘的原因复杂,充分的术前准备、正确使用吻合器、保证吻合口血供及加强术后管理是预防吻合口瘘的关键。

Treatment and prevention of anastomotic leakage after anterior resection for rectal cancer

Aim To explore the cause,treatment and management of anastomotic leakage after radical resection for rectal cancer and preservation of anal sphincter.Methods Clinical data of 276 rectal cancer patients,undergone sphincter preserving surgery from 2004 to 2010,were analyzed retrospectively.Results The incidence of anastomotic leakage among the 276 rectal cancer patients was 10.6%（26 patients）.4 patients were healed by second operation.Conclusion Tubular stapling applications has improved the anus rate in rectal cancer,and shortened operating time.Anastomosis becomes safe and reliable.The risk factors for the development of anastomotic leakage are complex.Good bowel preparation,correctly using stapling,ensuring anastomotic blood supply,strengthening the postoperative management are crucial to take precautions against anastomotic leakage.