51例直肠癌术后吻合口瘘的临床分析

Clinical Analysis of 51 cases of anastomotic leakage after the operation of rectal cancer

目的研究直肠癌术后发生吻合口瘘的若干临床因素。方法对1994年～2004年我院施行的1016例直肠癌前切除术后发生的51例吻合口瘘病例进行回顾性分析。结果肿瘤位于距肛门4cm～7cm 的直肠癌患者术后发生吻合口瘘的比率为7.03%,而肿瘤位于7cm 以上的直肠癌患者术后发生率为2.98%(P<0.05)。术前伴有不完全性肠梗阻的患者术后发生吻合口瘘的机率为6.28%,而其对照组的发生机率为4.26%(P<0.05)。传统术式组与 TME 组的吻合口发生率虽有一定差距,但与文献报道不甚相符,亦无统计学意义。结论直肠癌术后发生吻合口瘘是由多方面因素造成的,其中的一些因素我们若可以做到尽量避免,则可以减少甚至是避免吻合口瘘的发生。

Objective To investigate some problems about anastomotic leakage after the operation of rectal cancer.Methods The 51 cases of anastomotic leakage were from 1016 cases of operation of rectal cancer(Dixon's)from 1994～2004,and they were analyzed retrospectively in this article.Results In the group that tumors were in rectal 4～7cm from anus,the rate of anastomotic leakage was 7.03%,but in the group that tumor were in rectal above 7cm from anus,the rate was 2.98%(P<0.05).In the group complicated with partial intestinal obstruction, the rate of anastomotic leakage was 6.28%,but the rate of control group was 4.26%(P<0.05).Between the traditional group and TME group,though there was a little disparity on the rate of anastomtoic leakage,but there was not statistical significance.Conclusion There were many factors in the happening of anastomotic leakage after the operation of rectal cancer,if we can try our best to avoid some of them,then the rate of anastomtoic leakage can be reduced.