腹腔镜低位直肠癌保肛术后吻合口漏的临床分析

Analysis of anastomotic leakage of laparoscopic low rectal cancer dixon surgery

目的:探讨腹腔镜下低位直肠癌保肛术后吻合口漏的原因及防治措施。方法:回顾分析为45例低位直肠癌患者行腹腔镜保肛手术的临床资料。结果:45例手术均获成功,无一例死亡。术后3例发生吻合口漏,占6.7%。2例经局部引流、进食、肠外营养等保守治疗痊愈出院;1例行远端封闭,降结肠造瘘术(Hartman术式)。结论:低位直肠癌患者行腹腔镜保肛术后吻合口漏与术后远端肠管血供不足及吻合口张力较大密切相关,充分引流,早期进食、抗感染及肠外营养支持相结合是有效的治疗措施。

Objective：To analyze the causes, prevention and treatment of anastomotic leakage after laparoscopic low rectal cancer Dixon surgery. Methods： A retrospective analysis was performed on the clinical data of 45 patients who underwent laparoseopic low reetal cancer Dixon surgery. Results：Among 45 patients there were .3 cases with anastomotic leakage,ineidence for 6.7%. 2 cases were curd through conservative treatment such as local drainage,feeding and parenteral nutrition, 1 case was cured through Hartmail surgely, no deaths. Conclusions-Anastomotic leakage after laparoseopie low rectal cancer Dixon surgery is related to blood supply shortage of postoperative bowel anastomotic and the larger tension,adequate drainage, early feeding, antibiotics and parenteral nutritior