直肠癌前切除吻合口瘘的临床分析

目的探讨直肠癌保肛手术后吻合口瘘发生的原因、诊断、处理及预防措施。方法对15例直肠癌保肛术后出现吻合口瘘的病历资料进行回顾性分析。结果对185例直肠癌行前切除保肛手术,15例出现吻合口瘘,13例通过及时有效的引流、局部处理治愈,2例经结肠造口治愈。结论吻合口瘘是直肠癌保肛手术后最严重的并发症之一,与术前准备情况、手术操作技巧、吻合口血供、张力和骶前引流通畅情况有关;做好防治措施,可以减少和避免吻合口瘘的发生。

Clinical analysis of anastomotic leakage following low anterior excision of rectal cancer

Objective] To investigate the causes and diagnosis of anastomotic fistula following low anterior excision of rectal cancer, and its management and prevention measures. Methods] The clinical data of 15 patients with anastomotic leakage underwent anterior excision of rectal cancer were retrospectively analyzed. Results] 185 patients accepted anterior excision of rectal cancer, 15 patients developed anastomotic fistula. 13 patients were cured with effective pelvic drainage and 2 cases with ileostomy. Conclusions] Anastomotic fistula is one of the most serious complications related to preoperative preparation, blood supply and anastomotic tension, intraoperative techniques and effective drainage. It can be avoided or reduced by different prevention and treatment measures.