女性低位直肠癌前切除术后并迟发性吻合口-阴道瘘的临床分析

Clinical Analysis of Postponed Anastomotic Stoma-vagina Fistula in Women with Low Rectal Cancer:A Post-Anterior Resection Complication

目的探讨女性低位直肠癌前切除术后迟发性吻合口-阴道瘘的原因。方法回顾性分析13例女性低位直肠癌经腹前切除吻合术治疗后并迟发性吻合口-阴道瘘的临床资料。结果术后11～14d发生吻合口-阴道瘘9例,术后0.5～4个月发生吻合口-阴道瘘4例。结论低位直肠前壁大而晚的癌肿累及直肠-阴道膈、高频电刀对阴道后壁组织的延迟性热力损伤、术中拉钩挫伤阴道后壁组织以及吻合口可能嵌入部分阴道后壁组织等可能为女性低位直肠癌患者术后迟发性吻合口-阴道瘘发生的主要因素。

Objective To explore the reason of postponed anastomotic stoma-vagina fistula complicated in women with low rectal cancer after anterior resection. Methods We analyzed data of 13 female patients with low rectal cancer suffering postponed anastomotic stoma-vagina fistula after anterior resection,retrospectively. Results Among the 347 low rectal cancer patients receiving anterior resection,the incidence of postponed anastomotic stoma-vaglna fistula was 3.8% 13 patients. In details, 9 patients started to suffer the complication within 11-14 days after surgery,while the other 4 patients complained of it within 0.5-4m after surgery. Conehlsion The high risk factors of postponed anastomotic stoma-vagina fistula after anterior resection were as follows： large and local advanced lesione intruding the rectal-vagina septum, cunctative heat damage of vagina posterior wall by high frequency electrotome,vagina posterior wall contused by hook during operation,and a few tissue of vagina wall inset in anastomotic stoma.