低位直肠癌保肛术后吻合口漏的原因及防治

Reason and treatment of anastomotic leakage after anus-preserving operation for low rectal cancer

目的探讨低位直肠癌保肛术后吻合口漏的原因、预防及处理方法。方法对低位直肠癌全系膜切除低位吻合手术后吻合口漏的发生及治疗情况进行回顾性分析。对吻合口漏的患者采用保守治疗(经腹部引流冲洗和会阴引流管引流)及手术治疗。结果术后发生吻合口漏18例。采用保守治疗16例,行手术治疗2例,均痊愈出院。结论低位直肠癌保肛术后吻合口漏应以预防为主,满意的术前准备,掌握低位直肠癌保肛术要点并注重操作细节是预防吻合口漏的关键。恰当引流管放置以利于充分引流对吻合口漏的治愈具有重要意义。

Objective To explore the causes of anastomotic leakage after anus-preserving operation for low rectal cancer and investigate its prevention and treatment. Methods The data of 18 cases with anastomotic leakage after anus-preserving operation for low rectal cancer were analyzed retrospectively. The conservative treatment with irrigation through abdominal drainage tube and drain by perineal drainage tube,and the surgical operation were used in patients respectively. Results Eighteen patients were found to have anastomotic leakage after anus-preserving operation for low rectal cancer. All patients were recovered after conservative treatment for 16 patients and surgical operation for 2 patients. Conclusions The key to prevent anastomotic leakage is familiarity with operative main points,paying attention to details during the operation and the satisfactory preparation before operation. Placing drainage tube rightly so as to drain anastomotic leakage adequately has an important significance for cure of anastomotic leakage.