结肠癌根治切除术预防性放置腹腔引流管随机对照研究

Prospective randomized study of abdominal drains in colorectal cancer radical resection

目的探讨结肠癌根治切除手术时是否需要预防性放置腹腔引流管。方法将2005年6月至2009年6月我院手术治疗的结肠癌患者随机分为两组,(1)无腹腔引流组(59例),不放置腹腔引流管;(2)腹腔引流组(61例),常规放置腹腔引流管。两组均采用结肠癌根治切除术。使用相同的围手术期处理方法。观察两组术后恢复情况及术后并发症,并对其进行比较分析。结果无腹腔引流组与腹腔引流组相比,术后并发症发生率、肛门通气时间、恢复进食时间及术后住院时间差异均无统计学意义。两组术后均无死亡病例。无腹腔引流组术后疼痛指数明显降低。结论限期结肠癌根治切除术中不常规预防性放置腹腔引流管是安全可行的。

Objective To compare the safety and effectiveness of routine drainage and no-drainage regimes after selective colorectal cancer radical resection.Methods All patients received selective colorectal cancer radical resection were randomly divided into two groups：group I （no-drains,n=59）,group II （with drains,n=61）.The incidence of anastomotic leak and complications specific to the drain,as well as other complications were compared in the 2 groups.Results The mean length of postoperative stay was （12.8±2.7）d in group I and （13.1±2.8）d in group II （P0.05）,and postoperative days for oral intake were （5.2±1.8）d in group I and （5.5±1.6）d in group II（P0.05）.No significant difference was noted in the incidence of postoperative complications between the no-drain group and the drain group（11.9% vs.13.1%,P0.05）; however,the pain index in group 1 was significantly lower that in group II （P0.05）.Conclusions No routine abdominal drainage after colorectal cancer radical resection is safe and reliable,and routine abdominal drinage to prevent anastomotic leak and other complications is unnecessary.