摘要
目的:探讨全直肠系膜切除(TME)治疗低位直肠癌行保肛手术患者中吻合口漏的预防和治疗方法。方法:回顾性分析按TME原则手术的62例低位直肠癌行保肛手术的临床资料。结果:62例中,发生吻合口漏5例,占8.1%(5/62)。其中吻合器吻合52例,术后发生吻合口漏1例,占1.9%(1/52),经肛门结肠肛管吻合10例,发生吻合口漏4例,占40%(4/40)。5例吻合口漏保守治疗1例,结肠造口4例,均痊愈。结论:在低位直肠癌保肛手术中,充分的术前准备、保证吻合口的血供和吻合器使用得当可有效预防吻合口漏的发生;对术后吻合口漏视具体病情采用个体化治疗。
Objective:To investigate the means of prevention and treatment of anastomotic leakage in patients with low rectal cancer undergoing total mesorectal excision with sphincter preservation. Methods:The clinical data of 62 patients with low rectal cancer undergoing total mesorectal excision (TME) with sphincter preservation were analyzed retrospectively.Results:5 of the 62 cases developed anastomotic leakage pestoperatively,the incidence was 8.1%(5/62),and of 52 cases undergoing the anastomosis by stapfing technique, only 1 developed anastomotic leakage;while of 10 cases undergoing transsphincteric coloanal anastomosis,4 developed anastomotic leakage,the incidence was 1.9%(1/52) and 40%(4/10) respectively. In the 5 anastomotic leakage cases, 1 received expectant treatment,4 underwent colostomy,and all cases were cured saccessfully.ConclusIon:In the sphincter preservation operation for lower rectal cancer patients, adequate preoperative preparation,sufficient blood supply of the anastomotic stoma and proper application of stapler can prevent the incidence of anastomotic leakage;the anastomotic leakage developed postoperatively that should be treated based on the individual conditions.
出处
《现代医药卫生》
2008年第10期1426-1428,共3页
Journal of Modern Medicine & Health
关键词
低位直肠癌
吻合口漏
Low rectal cancer
Anastomotic leakage