直肠癌根治术骶前负压引流的应用

目的评价直肠癌根治术骶前负压引流的作用。方法对2002—06／2007—06因直肠癌行根治切除术116例进行回顾性分析，比较骶前引流在经腹会阴切除术以及前切除、低位前切除术中应用对创口及切口愈合的影响。结果经腹会阴切除加骶前引流，会阴创口1期愈合69例（87．3％），感染4例（5．1％），延迟愈合6例（7．6％），创口愈合时间平均13d。前切除及低位前切除加骶前引流，切口1期愈合31例（83．8％），切口感染3例（9．7％），盆腔感染3例（9．7％），1期愈合率高，愈合时间短，感染率低，无吻合口瘘。结论直肠癌根治术中骶前双管引流、封闭式负压吸引的方法，在经腹会阴切除以及前切除、低位前切除是必要的。

Application of Negative Pressure Drainage on Presacral in Radical Resection of Rectal Carcinoma

Objective To evaluate the effect of negative-pressure drainage in the front of sacrum in radical resection of rectal carcinoma.Methods There were 116 cases undergoing radical resection of rectal carcinoma from June of 2002 to June of 2007,including 79 cases by abdominoperineal resection (APR) with pelvic floor fascia stitched and double-tube drainage,12 cases by anterior resection(AR),25 cases by low anterior resection (LAR).Result In abdominoperineal resection group,69 cases (87.3%) were healed by first intention,4 cases ( 5.1%) were infected and 6 cases(7.6%) of wound healing was delayed. The average healing time of wound was 13 days. 83.8% (31 cases) of anterior resection and low anterior resection were healed by first intention. Incision infection and pelvic cavity infection accounted for 9.7% (3 cases) and 9.7% (3 cases) respectively,and there were no anastomose fistula. Conclusions The double-tube and negative pressure closed drainage in the front of sacrum was significantly important in abdominoperineal resection of radical resection for rectal carcinoma. Whether drainage should be used or not depended on different conditions in the process of anterior resection and low anterior resection.