低位直肠癌保肛术后吻合口瘘防治

 【摘要】　目的　分析低位直肠癌保肛术后发生吻合口瘘的主要原因与防治措施。方法　回顾性分析1999年6月至2007年6月513例低位直肠癌保肛术后并发吻合口瘘23例患者的临床资料。结果　23例（4.5 %）发生吻合口瘘患者中20例（87.0 %）经非手术治疗痊愈，3例（13.0 %）并发腹膜炎行开腹处理后亦成功保肛。结论　低位直肠癌保肛术后吻合口瘘与术前胃肠道准备、Duke分期、合并糖尿病及术后早期腹泻等有关。诊断一经确定，积极采取三阶段疗法，多数患者可经保守治疗治愈。

Prevention and treatment of anastomotic leakage following anterior resection for low rectal cancer

【Abstract】　Objective　To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotic leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients． Methods　The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results　The incidence of anastomotic leakage was 4.5 % (23/513)． 20 patients underwent conservative therapy，while 3 patients underwent reoperation. all patients were cured without ileostomy or colostomy. Conclusion　The occurrence rate of anastomotic leakage is closely re－lated to the type of operation, the Dukes staging, Diabetes Mellitus and Diarrhea． Local irrigation via the drainage tube is the main strategic point to manage the leakage．