带蒂网膜在低位直肠癌保肛术中的应用观察

Application of Omentum with Pedicle in Anal Preservation Operation in the Treatment of Low Rectal Carcinoma

观察低位直肠癌保肛术中应用带蒂网膜环形袖套状包裹结直肠吻合口，防止吻合口漏发生的效果。沿无血管区将大网膜从横结肠上解剖游离，保留胃网膜右血管，用带蒂网膜环形袖套状包裹结直肠吻合口，并填充于骶前。结果46例低位直肠癌直肠前切除结直肠吻合中，应用该法21例，术后无吻合口漏及腹腔感染发生；未用该法者25例，术后发生吻合口漏2例。结果表明，带蒂网膜环形袖套状包裹低位直肠癌结直肠吻合口．可有效防止吻合口漏的发生及腹腔感染。

The objective of this study was to prevent anastomotic leakage by following method. The greater omentum was freed from the transverse colon along the non-blood-vessel zone, the right blood vessel of gastro-omentum was preserved, and the rectocolonic anastomotic stoma was wrapped into a circular ＆ sleeve-shaped form, which was lastly packed at anterior sacrum. Forty six cases with low rectal carcinoma underwent prerectal resection and low colorectal anastomosis,in which the rectocolonic anastomotic stoma was wrapped with omentum in 21 cases,resulting in no occurrence of anastomotic leakage or abdominal infection. The rest 25 cases did not receive the omentum-wrapped procedure,resulting in anastomotic leakage in 2 cases. It is suggested that this omentum-wrapped procedure can effectively prevent the occurrence of anastomotic leakage and abdominal infection.