Dixon术应用器械吻合术后吻合口漏的原因分析

Analysis on Leakage of Stapling Stomas after Anastomosis with Instruments in Dixon Operation

目的 分析Dixon术应用器械吻合术后吻合口漏的原因。方法 通过对本院近年来 2 46例中上段直肠癌施行Dixon术应用器械吻合出现吻合口漏的各种原因进行分析比较。结果 病灶距肛门≤ 8cm组和吻合二次以上者吻合口漏发生率较高 ,差异有显著性意义和高度显著性意义。结论 认为吻合口漏的发生与以下原因有关 :①手术适应证掌握不当 ;②器械操作不够熟练 ;③吻合口张力过大 ;④吻合口血供不良 ;⑤术前肠道准备不完善和术中污染。

Objective To analyse the reasons for the leakage of stapling stomas after amastomosis with instruments in Dixon operation.Methods To collect the reasons for all kinds of leakage of stapling stomas by means of comparing the 246 cases in our hospital in recent years,in which the patients had rectal cancer in the middle and/or upper section and were given anastomosis with instruments in Dixon operation.Results The occurrence rate of leakage of stapling stomas was higher under the two circumstances:(a)The distance was 8 cm or less between focus and anus;(b) Anastomosis was applied more than twice.This proved to be definite with significance notably or even in high degree.Conclusions In our opinion the leakage of stapling stomas is concerned with the following factors:①Operational indication is inappropriately controlled;②Instruments can′t be skillfully operated;③Tension of stapling stomas is too strong;④Blood around stapling stomas is in short supply;⑤Ample preparations for intestinal channels aren′t made before operation and it is likely to make the patients get pollution during anastomosis.