直肠癌保肛术后吻合口瘘11例分析

Management of anastomotic leakage after anus-preserving operation in patients with rectal cancer:a report of 11 cases

目的：探讨直肠癌保肛术后吻合口瘘发生的原因、诊断、处理及预防措施。方法：对2002年1月至2009年8月施行直肠癌保肛手术后吻合口瘘11例的临床资料进行回顾性分析。结果：直肠保肛术后吻合口瘘发生率为9.8%,其中10例经非手术治疗痊愈,1例再次手术治疗痊愈。结论：充分的术前准备,重视吻合口的血运、张力,正确使用吻合器,合理选放引流管是防止瘘发生的关键。及时有效的引流,绝大多数可获痊愈。

Objective：To investigate the causes,management and preventive measures for anastomotic leakage after radical resection for rectal cancer.Methods：From Jan.2002 to Aug.2009,11 cases of anastomic leakage after 112 cases of anus-preserving operation were retrospectively analyzed.Results：The incidence of anastomotic leakage was 9.8%.Ten of the cases received non-surgical treatment and 1 case recovered after re-operation.Conclusions：Adequate preoperative preparation,proper attention to the blood supply and tension of the anastomosis,rational use of the stapler,reasonable selection of the drainage tube are key to the prevention of fistula.By effective and timely drainage,most of the anastomotic leakage can be cured.