全直肠系膜切除(TME)术后吻合口漏的预防和治疗

目的探讨中低位直肠癌全直肠系膜切除术后吻合口漏的预防和治疗。方法回顾性分析1993年10月至2005年6月本院收治289例中低位直肠癌全直肠系膜切除术的临床资料。结果289例中低位直肠癌术后发生吻合口漏13例（4．5％），其中12例经治疗痊愈。1例死亡。结论中低位直肠癌全直肠系膜切除术后吻合口漏的发生率较高，预防上要采取多方面措施，预防性结肠造瘘并无必要。低位吻合口漏的治疗应尽早采取近端结肠造瘘术。

Prevention and treatment for anastomotic leakage after total mesorectal excision

Objective To investigate prevention and treatment methods of anastomotic leakage after total mesorectal excision(TME) for mid or low rectal adenocarcinoma. Methods Clinical data on 289 cases with mid or low rectal adenocarcinoma treated with TME ,from October 1993 to June 2005,were retrospectively analyzed. Results Of the 289 cases, 13 cases developed an anastomotic leakage.12 cases were recovered , 1 case died during the perioperative period. Conclusions The rate of anastomotic leakage after TME for mid or low rectal adenocarcinoma was high.Many treatment methods should be used to prevent anastomotic leakage.Routine using preventive colostomy after TME was not necessary.Proximal colostomy was necessary to treat low anastomotic leakage.