结直肠钉式吻合术后吻合口并发症的治疗和预防

Treatment and Prevention of Anastomosis Stoma Complications Following Colorectai Nail-mode Anastomosis

为有效防治结直肠钉式吻合术后并发症，本研究回顾分析2003年1月至2010年1月于我院行结直肠钉式吻合的88例低位直肠癌患者资料，对其术后并发症进行总结，并对发生原因进行分析。结果显示，本组无手术死亡病例；术后吻合口出血2例（2．3％），吻合口漏2例（2．3％），吻合口狭窄5例（5．7％），创口感染8例（9．1％），吻合钉外露5例（5．7％），局部复发3例（3．4％），远处转移2例（2．3％）。结果表明，结直肠钉式吻合术治疗低位直肠癌术后并发症除与患者身体状况、手术条件和操作医师的熟练程度有关外，与钉式吻合器本身也有很大关系，术中应正确使用钉式吻合器。

In order to effectively prevent and treat anastomosis stoma complications following eolorectal nail-mode anastomosis in the treatment of low rectal cancer, authors retrospectively analyzed the data of 88 patients with low rectal cancer who had received colorectal nail-mode stapler anastomosis from Jan. 2003 yr. to Jan. 2010 yr. ,summarized its postoperative complications and found out their causes. As results, in this study there were no operative death cases,postoperative bleeding from anastomosis stoma occured in 2 cases（2.3%） ,anastomosis stoma leakage in 2 cases（2.3%） ,anastomosis stoma stenosis in 5 cases（5.7%）, wound infection in 8 cases（9.1%） ,anastomosis nail exposed outside in 5 cases（5.7%） ,local recurrence in 3 cases（3.4%） ,distant metastasis in 2 cases（2.3%）. Results show that above-mentioned anastomosis stoma complications are also related to nail-mode stapler greatly, except for patient-self body condition, objective factor for operation and skill degree of operator, therefore it should be correctly to use nail-mode stapler.