不同引流方法预防直肠癌前切术后吻合口瘘的效果

目的 前瞻性观察直肠癌前切除术后3种不同引流方法预防吻合口瘘的效果.方法 2002年1月～2007年1月,450例中高位直肠癌并接受前切除术患者按人院次序随机均分为A、B、C3组.A组接受骶前引流;B组接受骶前引流+经肛单管引流;C组接受骶前引流+经肛双管引流,对3组患者的术后并发症进行对比分析.结果 A、B、C组切口感染发生率分别为7.33%(11/150)、8.00%(12/150)、6.67%(10/150),吻合口瘘发生率分别为8.67%(13/150)、6.67%(10/150)、1.33%(2/150).C组吻合口瘘率显著低于A、B两组(P＜0.05);A、B、C组间切口感染发生率差异无统计学意义(P＞0.05).结论 骶前引流+经肛双管引流能有效地预防直肠癌前切除吻合术后吻合口瘘的发生.

Effects of different postoperative drainages on preventing anastomotic leakage after Dixon operation in rectal carcinomas

Objective To investigate prospectively effects of different drainage methods on preventing anastomotie leakage after Dixon operation in rectal carcinomas.Methods During the period of January 2002 to January 2007,450 patients with rectal carcinomas received Dixon operation.They were divided into three groups ( group A,B,and C) in order of admission.Presacral drainage was done in Group A,presaeral drainage + drainage through anus with one tubes in Group B,and presacral drainage + drainage through anus with two tubes in Group C.The postoperative complications of three groups were observed.Results There was 7.33% (11/150) ,8.00% (12/150) and 6.67% (10/150) wound infection in group A,B and C respectively.8.67% (13/150),6.67% (10/150) and 1.33% (2/150) anastomotic leakage occurred in group A,B and C respectively.Three groups had a similar wound infection ineidence(P ＞0.05).The occurrence of anastomotic leakage in group C was statistically lower than that in group A and B ( P ＜ 0.05 ).Conclusion Presacral drainage + drainage through anus with two tubes can effectively prevent anastomotic leakage after Dixon operation in rectal carcinomas.