大肠癌术后吻合口漏的原因探讨及处理

 目的　探讨大肠癌术后吻合口漏的原因及治疗方法。方法　对我院近二年来收治的 15 5例大肠癌的临床资料进行回顾性分析。结果　 15 5例手术患者中共发生吻合口漏 9例 ,发生率为 5 .8%。吻合口在腹膜外的归为腹膜外吻合组 ;吻合口在腹腔内的归为腹腔内吻合组。前期 10 8例中行腹膜外吻合 35例 ,吻合口漏发生率为 17.1% (6 /35 ) ;行腹腔内吻合 73例 ,吻合口漏发生率为 4 .1% (3/70 )。二组比较有显著性差异 (P <0 .0 5 )。后期 4 7例手术中 ,术后行直肠内引流 ,均一期愈合。结论　行肠腔内引流以降低肠腔内压是减少吻合口漏的一种方法。吻合口漏的处理是通畅引流 ,促进漏口自行愈合 ,手术是最后的治疗措施

Cause discussion and treatment of postoperative leak in large intestine carcinoma

Objective To study the reasons and treatments of postoperative leak in large intestine carcinoma. Method To make retrospective analysis for 155 cases of large intestine carcinoma in the past two years of our hospital. Results There are 9 anastomotic leakage in 155 cases. The incidence rate is 5.8%. We take Dixon and Park's operation as extraperitoneal group (the incidence of leak is 17.1%,6/35 cases) and compare with intraperitoneal group (the incidences of leak is 4.1% ,3/70 cases),the difference is significant( P <0.05).There are 9 anastomotic leakage in 108 cases that treat with normal therapy.In the other 47 cases we used anal canal to drain from rectumand get first intention ( P <0.05,significant difference). Conclusion The reasons of anastomotic leakage are systemic and topical. To decrease the pressure of intestinal cavity by drain from intestine is a very good method.The treatments of anastomotic leakage are making drain unobstructed and push leakage healed. The final treatment is operation.