肠镜在腹腔镜辅助低位直肠癌根治术后吻合口出血防治中的意义

目的:探讨肠镜在腹腔镜辅助低位直肠癌根治术后吻合口出血防治中的意义。方法 :回顾性分析我院2006年1月至2011年12月共279例腹腔镜直肠癌根治术病人的资料,其中18例术后吻合口出血。采用卡方检验分析影响吻合口出血的可能因素,对于P

Colonoscopy for assessment and treatment of anastomotic bleeding in laparoscopic-assisted radical resection of lower rectal cancer

Objective To investigate the value of colonoscopy on prevention and treatment of postoperative anastomotie bleeding of laparoscopic-assisted radical resection for lower rectal cancer. Methods Medical records of 279 cases with laparoscopic radical resection for rectal cancer from January 2006 to December 2011 were analyzed in this retrospective study. There were 18 cases of postoperative anastomotic bleeding. Chi-square test was used to analyse the potential factors in anastomotic bleeding. Logistic regression of multivarible was performed with the influencing factors of P 〈0.05 for analysis of anastomotic bleeding associated with tumor location and intraoperative colonoscopy. The treatment of anastomotic bleeding was also evaluated. Results The incidence of postoperative anastomotic bleeding was 6.5% （18/279）. All were treated successfully with 7 cases of conservative treatment, 9 cases colonoscopic hemostasia and 2 cases reoperation. The rates of anastomotic bleeding in lower tumor, and upper turrlor, intraoperative colonoscopy and non- intraoperative colonoscopy were 9.2% （16/173）, 1.9% （2/106）, 3.3% （5/151） and 10.2% （13/128）, respectively. The postoperative bleeding was not related to age, gender, tumor size, tumor stage, pathological differentiation and preventive ileostomy. The relative risk was 4.776 for lower tumor when compared with upper tumor. The relative risk was 0.338 for intraoperative colonoscopy compared with non-colonoscopy. Conclusions lntraoperative colonoscopy may be an independent influencing factor for prevention of anastomotic bleeding after laparoscopic assisted radical resection of lower rectal cancer. Colonoscopic hemostasis is recommended for the treatment of anastomotic bleeding.