回肠造口预防低位直肠癌吻合口漏的作用分析

The Roles of lleostomy in the Prophylaxis of Anastomotic Leakage in Operation of Low Rectal Cancer

探讨预防性回肠造口对减少低位直肠癌术后吻合口漏的意义。回顾性分析低位直肠癌行Dixon术患者中，施行回肠造口与未施行患者的临床资料及吻合口漏发生情况。结果显示，46例未行回肠造口组患者5例发生吻合口漏，68例行回肠造口患者1例发生吻合口漏（P〈0．05）;造口组平均住院时间11．2d，未造口组平均住院时间15．8d（P〈0．05）。两组共6例吻合口漏患者，分别存在糖尿病、长期使用激素、术前放疗、不全性肠梗阻等因素。结果表明，回肠造口能有效降低低位直肠癌吻合口漏的发生率，减少患者初次住院负担。对术前评估有发生吻合口漏高风险患者应常规行预防性回肠造口术。

In order to study the role of ileostomy in the prophylaxis of anastomotic leakage after operation of low rectal cancer, authors retrospectively analysed the anastomotic leakage and clinical information of patiens with low rectal cancer. As results,5 patients appeared anastomotic leakage in 46 patiens who had not been subjected to ileostomy,whereas 1 patient appeared anastomotic leakage in 68 patients who undergone ileostomy,there was significant difference between the two groups（ P〈0.05）. The average hospital stay of patients without ileostomy were 15. 8d, whereas the average hospital stay of patients with ileostomy were 11.2d, there was significant difference between the two groups（ P〈0.05）. There were diabetes, long-time hormone administration, preoperation radiotherapy, incomplete intestinal obstruction, etc, with 6 pa role The tients with anastomotic leakage of the two groups, respectively. Above mentioned results show that of ileostomy in the prophylaxis of anastomotic leakage after operation of low rectal cancer is valuapatients with high risk of anastomotic leakage should undergo ileostomy routinely.