经会阴引流在防治直肠癌Dixon术后吻合口瘘中的作用

目的:评价经会阴骶前引流对防治直肠癌Dixon术后吻合口瘘的作用;方法:回顾分析我院1995年10月~2005年10月直肠癌前切除术351例,按术后经会阴骶前引流和经腹盆底引流分为两组,比较两组瘘的发生率,腹膜炎的发生率,瘘发生后的处理方式,平均愈合时间。结果:在经腹腔盆底引流组(A)和经会阴骶前引流组(B)中,吻合口瘘发生率分别为6.67%(10/150)和2.49%(5/201),具有统计学意义(P<0.05);腹膜炎A组6/10,B组0;瘘发生后A组7例行结肠外置术,B组5例均经冲洗引流而愈,未行二次手术;吻合口平均愈合时间:A组为28天;B组为12天。结论:经会阴骶前引流在防治直肠癌Dixon术后吻合口瘘中起着非常重要的作用。

The role of draining by perinaeum in prevention and treatment of anastomotic fistula after Dixon operation in rectel cancer patients

Objective:To evaluate the role of different draining approaches in prevention and treatment of anastomotic fistula after Dixon operation. Methods: Retrospective study was employed to analyze the experience of drainage after Dixon operation for 351 patients with rectal cancer from 1995 to 2005. Results: The incidence rates of anastomotic fistula by abdominal cavity drainage in the group(A) and by perineum drainage in the group(B) were 6.67%(10/150)and 2.49%(5/201) respectively (P<0.05); Peritonitis in group A and B were 6/10 and 0, respectively,7 patients in group A received colostomy after fistula,5 patients in group B had been cured by washing the drainage tube. The average cure time of anastomotic fistula in group A was 28 days ,while that in group B was 12 days. Conclusion: The drainage of anterior sacral surface by perineum plays a very important role in prevention and treatment of anastomotic fistula after Dixon operation.