直肠肛管内外双引流预防直肠低位吻合口瘘的发生

目的探讨直肠肛管内、外双引流在预防直肠低位吻合口瘘的作用。方法将235例行直肠低位前切除术的患者按不同时间段分成前期组（2003年3月至2004年8月）和后期组（2004年9月至2007年11月）。后期组患者的围手术期处理有所改进，特别是常规行直肠肛管内、外双引流。分别比较两组患者的吻合口瘘发生率和相关的临床病理资料。结果前期组89例患者中4例（4．5％）发生吻合口瘘，后期组146例患者中1例（0．7％）发生吻合口瘘。Logistic回归分析发现．是否行直肠肛管内、外双引流是影响吻合口瘘发生率的主要因素。结论直肠肛管内、外双引流能有效预防直肠低位吻合口瘘的发生。

Effect of intra- and out-anorectal drainage in the prevention of anastomotic leakage after low anterior resection

Objective To investigate the effect of intra- and out-anoreetal drainage in the prevention of anastomotie leakage after low anterior resection (LAR). Methods Two hundred and thirty-five patients undergone LAR were divided into two groups according to two periods, the former group from Mar. 2003 to Aug. 2004 and the later group from Sep. 2004 to Nov. 2007. Technique advances were adopted in the later group, especially the routine intra- and out-anorectal drainage. Incidence of anastomotic leakage and clinicopathological data of two groups were compared. Results Anastornotic leakage oeeurred in 4 patients of the former group (4/89) and 1 of the later group (1/146). Logistic analysis found that intra- and out-anorectal drainage was the main issue which prevented anastomotie leakage. Conclusion Intra- and out-anoreetal drainage is useful for the prevention of anastomotic leakage after low anterior resection.