肠系膜下动脉高位结扎对直肠癌根治术后发生吻合口瘘的影响

目的分析直肠癌根治术后导致吻合口瘘发生的危险因素,探讨高位结扎肠系膜下动脉对患者直肠癌术后吻合口瘘的影响。方法对2005年8月至2013年8月期间307例行直肠癌根治术患者（年龄≥60）的临床资料进行回顾性分析。结果 307例患者中,有30例术后发生吻合口瘘（9.8%）,其中患者的性别、肿瘤位置及术中失血量为术后吻合口瘘发生的危险因素（P〈0.05）。高位结扎肠系膜下动脉主要与患者肿瘤TNM分期及术后尿潴留发生率相关（P〈0.05）,但并未增加手术后吻合口瘘的发生率（P〉0.05）。结论引起直肠癌根治术后吻合口瘘的危险因素为性别、肿瘤位置及术中失血量,高位结扎肠系膜下动脉不是直肠癌术后吻合口瘘发生的危险因素。

Study of the influence of high ligation of the inferior mesenteric artery on anastomotic leakage after rectal cancer resection in elderly patients

Objective To analyze risk factors for anastomotic leakage,and study the influence of high ligation of the inferior mesenteric artery on anastomotic leakage after rectal cancer resection. Methods Clinical data were retrospectively analyzed for 307 patients（ age≥60 years） who underwent rectal cancer resection between August 2005 and August 2013. Results Anastomotic 1eakage occurred in 30 cases in 307 patients（ 9. 8%）,of which sex,tumor location and intraoperative blood loss were anastomotic fistula risk factors（ P〈0. 05）. High ligation of the inferior mesenteric artery in patients was primary associated with tumors TNM stage and the incidence of postoperative urinary retention（ P〈0. 05）,but did not increase the incidence of anastomotic leakage rate（ P〈0. 05）. Conclusions Anastomotic leakage after rectal cancer resection is related tomale gender,the tumor level,and perioperative bleeding,use of a high tie was not associated with an increased rate of symptomatic anastomotic leakage.