从手术操作细节预防直肠肿瘤患者保肛术后吻合口瘘的发生

目的：探讨预防低位Dixon手术后吻合口瘘的要点。方法：对连续进行的146例低位Dixon手术进行分析,手术在直肠系膜全切除基础之上,行经腹根治性切除。于直肠上动脉根部双重结扎,吻合部位直肠系膜要剃除干净。吻合口在距肛缘3 cm以内时放置肛管,所有患者均经会阴部戳孔放置骶前引流管。结果：146例均未发生吻合口瘘。术后并发症包括吻合口渗血2例、狭窄3例;大便次数增多48例,每日排便4～6次;有肛门刺激症状者34例;稀便控制能力差6例。结论：确保吻合部位血液供应良好、无张力、准确对合和积极治疗合并的全身性疾病是预防吻合口瘘的要点。

Prevention measures of anastomotic leakage in the lower Dixon operation in patients with rectal neopeasms

Objective:To analyze the main factors for prevention of anastomotic leakage in the lower Dixon operation.Methods: Procedure and experience of 146 cases of lower anterior resection operation with no anastomotic leakage were summarized and analyzed.Operative procedure complied with TME.Superior rectal artery was double ligated at the superior extremity.Mesorectum at the anastomosis site must be shaved and the stoma should be placed below the pelvic peritoneum.Drain were placed at pelvic kidney through perinei...