直肠癌低位前切除术吻合口漏的防治

目的：探讨直肠癌低位前切除术吻合口漏的原因、预防及处理方法。方法：采用双吻合技术施行直肠癌低位前切除术39例,术后引流管放置到病人进食排便后5天酌情拔除,每日扩肛。对发生吻合口漏者改进无渣或少渣饮食,局部冲洗,漏口处周围腔隙明显减小后及时将引流管拔至漏口以下水平。结果：39例中发生吻合口漏3例。原因分别为吻合不确切、吻合口存在感染因素及吻合口存在潜在缺血区域,均经非手术治疗愈合。其中明显漏1例术后半年内吻合口狭窄,1年后恢复正常,微小漏2例无吻合口狭窄。结论：掌握直肠癌低位前切除术要点并注重操作细节是预防吻合口漏的关键。恰当调整引流管放置时间和位置对吻合口漏的及时发现及预后具有重要意义。

Prevention and Treatment for the Anastomotic Leakage after Low Anterior Resection of Rectal Cancer

Objective:To explore the causes of anastomotic leakage after low anterior resection of rectal cancer and investigate its prevention and treatment. Methods:Low anterior resection of rectal cancer by using double stapling technique was performed on 39 patients. The drainage tubes were pulled out after the patients could eat and defecate for five days,their anuses were expanded everyday. Those patients,who suffered from anastomotic leakage,were ordered to eat liquid diet or low residue diet,and accepted freque...