结直肠钉式吻合术后并发症与肛门功能的临床观察

The Clinical Observation of the Complications and Anal Function After Colorectal Anastomosis with Stapling Technique

目的探讨结直肠钉式吻合术后并发症发生率及吻合口功能状态。方法回顾性分析94例结直肠癌的临床病理特点、吻合方式、术后肛门功能情况及预后。结果本组无手术死亡病例;术后吻合口出血3例(3.2%),吻合口瘘5例(5.3%),吻合口狭窄7例(7.4%),切口感染4例(4.3%),局部复发或远处转移4例(4.3%)。结论吻合器的应用效果令人满意,特别是在预防吻合口瘘和狭窄的发生中起到重要作用;肛门功能和吻合口平面有关,放疗是影响排便功能的重要因素。徐忠法氏评价标准对肛门功能可做出比较准确的判断,值得大力推广。

Objective To evaluate the incidence of complications after colorectal anastomosis with stapling technique and to analyze the anus function.Methods The clinicopathological features,anastomosis methods,anus function and prognosis of 94 cases with colorectal cancer were retrospectively analyzed.Results No operative death was observed,complications included anastomotic bleeding of 3 cases（3.2%）,anastomotic fistula of 5 cases（5.3%）,anastomotic stenosis of 7 cases（7.4%）,wound infection of 4 cases（4.3%）,local recurrence and metastasis occurred of 4 cases（4.3%）.The anus function correlated with the anastomotic levels.Radiation therapy was an important influencing factor on the anal function.Conclusion The application of stapling technique is effect,especially played an important role in the prevention of anastomotic fistula and stenosis.Xu Zhongfa＇s evaluation criteria is worthy to be popularized for the advantages of accurate judgments in anus function.