直肠癌保肛术后发生吻合口漏的临床分析

目的探讨经腹直肠癌根治术（Dixon）后发生吻合口漏的原因和防治方法。方法回顾性分析在我院2004年9月～2012年6月行经腹直肠癌根治术（Dixon）的107例临床资料，所有病例根据肿瘤距肛缘的距离即上段≥8cm和下段〈8cm而分为高位前切除术组47例和低位前切除术组60例，观察患者手术临床情况。结果107例中共有11例发生临床吻合口漏，总的吻合口漏发生率为10．28％。其中高位前切除术组2例．占高位前切除术组的4．25％；低位前切除术组9例，占低位前切除术组的15％。无死亡病例。结论经腹直肠癌前切除术后吻合口漏发生的原因并不单一；术前、术中和术后多方面预防能降低术后吻合口漏的发生率：吻合口漏发生后以保守治疗为主．多数吻合口漏可痊愈。

Clinical analysis of anastomotic leakage after rectal cancer anus-saving surgery

Objective To explore the causes and prevention methods of anastomotic leakage occurred after the transab- dominal radical resection of rectal cancer （Dixon）. Methods Clinical information of 107 patients having received the trans- abdominal radical resection of rectal cancer （Dixon） from September 2004 to June 2012 in our hospital was analyzed ret- rospectively. Based on the distance from tumor to anal verge, namely upper segment ≥ 8 cm and lower segment 〈 8 cm, the patients were divided into the high anterior resection group with 47 patients and the low anterior resection group with 60 patients. The surgical clinical situation of the patients was observed. Results Of the 107 patients, 11 patients had clinical anastomotic leakage, with the total anastomotic leakage rate of 10.28%, of which 2 patients were from the high resection group, accounting for 4.25% of the high resection group, and 9 patients were from the low re- section group, accounting for 15% of the low resection group. No death was observed. Conclusion The causes of anas- tomotic leakage occurred after the transabdominal anterior resection of rectal cancer are diverse. Preoperative, intraop- erative and postoperative muhifaceted prevention can reduce the incidence of anastomotic leakage. After the anasto- motic leakage occurs, conservative treatment is the main therapy and most anastomotic leakage can be cured.