末端回肠气管导管造瘘术预防低位直肠癌根治术吻合口漏的临床应用

目的探讨末端回肠气管导管造瘘术在低位直肠癌保肛术中预防吻合口漏的应用价值。方法 2013年7月~10月我科对15例低位直肠癌患者行低位直肠癌根治术(Dixon),术中应用7号气管导管经末端回肠置管造口。结果本组手术时间3~4 h,术中造瘘时间8~10 min。术后第7 d出现吻合口漏1例(6.7%),造瘘管处腹壁疼痛1例,一过性造瘘管梗阻2例,无再次手术病例。结论末端回肠气管导管造瘘术是一种安全的造瘘方法,能有效预防和治疗低位直肠癌根治术后吻合口漏。

The Clinical Value of Terminal Ileostomy with Endotracheal Tube in Preventing Anastomosis Leakage after Radical Resection of Low Rectal Cancer

Objective To evaluate the value of terminal ileostomy with endotracheal tube in preventing anastomosis leakage after radical resection of low rectal cancer. Methods A total 15 rectal cancer patients admitted from July to October 2013 were received terminal ileostomy with No. 7 endotracheal tube following radi- cal excision of low rectal cancer （Dixon）. The postoperative incidence of anastomosis leakage was observed. Results The operative duration was 3 to 4 hours, and the intra-operative fistulization time was 8 to 10 mi- nutes. Anastomotie leakage was found in 1 case, and the incidence was 6.7%. Abdominal wall ache located in stoma was appeared in 1 ease, and transient obstruction of stoma catheter was in 2 cases. No case was per- formed reoperation. Conclusion Anastomosis leakage after radical excision of low rectal cancer could be prevented and treated effectively by terminal ileostomy with endotracheal tube.