直肠癌前切除术后吻合口漏的预防和治疗

目的探讨直肠癌前切除术后吻合口漏的预防和诊疗。方法回顾性分析2000年1月-2007年10月在我院行直肠癌前切除术161例患者的临床资料。结果161例直肠癌前切除术后吻合口漏11例（6.8％），9例保守治疗治愈，2例横结肠造瘘治愈。结论直肠癌前切除术后吻合口漏的发生率较高，应以预防为主，术后体温、血常规、腹部体征及引流物异常有助于吻合口漏的早期诊断；引流管通畅引流、冲洗、抗感染辅以TPN和横结肠造瘘是治疗吻合口漏的主要方法。

Clinical study of anastomotic leakage following anterior resection for rectal cancer

Objective To study the reason and effective treatment of anastomotic leakage after anterior resection for rectal cancer. Methods The data of 161 cases with anterior resection operation for rectal cancer from January 2000 to October 2007 in our hospital were analyzed and compared retrospectively. Results 11 patients were found to have anastomotic leakage in 161 with anterior resection operation （incidence rate was 6.8%）. The 11 patients were all recovered after treatment conventional treatment of irrigation and drainage in 9 patients, and 2 patients were treated by operation. Conclusion Satisfying preparation before operation and perfect anastomotic technology play key roles in anastomotic leakage; correct judgement and valid method are premises of cure ; irrigation and drainage through presacral double tube is a simple, safe and less suffering method to treat anastomotic leakage.