直肠癌前切除术吻合口瘘的预防和治疗

THE PREVENTION AND TREATMENT OF ANASTOMOTIC LEAK-AGE IN ANTERIOR RESECTION OF RECTAL CARCINOMA

报告直肠癌前切除术并发吻合口瘘19例。重点讨论了发生吻合口瘘的相关因素。强调吻合口区良好血供、避免张力吻合及彻底盆腔引流是预防吻合口瘘的关键。对于瘘口较大、症状较重、全身情况差者要及时行近端结肠造口术。

This paper reported 19 patients with anastomotic leaks in anterior resection of rectal cancer. Anastomotic technique bowel preparation, anastomotic ischaemia and pelvic drainage are important predisposing factors. The key points preventing such complication include pulsatile colonic blood supply avoidance of tensile suture, and a clean dry pelvic cavity. Transverse colosto-my is needed if a major leakage occurs, especially with severe symptoms or a poor general condi-tion.