低位直肠癌前切除术吻合口瘘17例原因分析

目的: 探讨低位直肠癌前切除术吻合口瘘的易发原因及预防措施。方法: 分析低位直肠癌前切除术后发生吻合口瘘17例的临床资料。结果: 315例采用全系膜直肠切除(total mesorectal excision,TME)技术行低位直肠癌前切除患者中,发生吻合口瘘17例,瘘口愈合时间为(24.2±11.3)天;2例采用手术重置引流管顺利痊愈;保守治疗15例,13例痊愈,2例死亡。结论: 直肠癌前切除术后吻合口瘘的比例不高,手术技巧、术前准备、全身状态及引流等是吻合口瘘的主要相关因素。

Clinical study of anastomotic leakage following anterior resection for low rectal cancer

Objective: To investigate the cause and the prevention of anastomotic stoma fistula after total mesorectal excision for low rectal cancer.Methods: The results of surgery for distal rectal cancer with total mesorectal excision(TME) were reviewed.Results: Totally 315 patients underwent low anterior resection with TME in our hospital from 2002 to 2006.Seventeen of 315 patients treated by resection and anastomosis developed a clinically significant anastomotic leakage.The fistula healing time was(24.2±11.3) days.Two patients who were managed operatively were cured.Fifteen patients were managed conservatively.Thirteen of 15 were cured while the other both died.Conclusions: The incidence of anastomotic leakage is relatively low.There are many causes leading to the anastomotic fistulas which include operative capacity,preoperative preparation and total immunutrion and drainage.