腹腔镜直肠癌根治术后吻合口漏的临床分析(附4例报告)

Clinical analysis of anastomotic leakage after laparoscopic radical resection for rectal cancer:with a report of 4 cases

目的:探讨腹腔镜直肠癌根治术后吻合口漏的原因及防治措施。方法:回顾分析2011年5月至2012年6月为23例患者行腹腔镜直肠癌根治术的临床资料。结果:术后4例发生吻合口漏,其中1例伴发腹膜炎,再次行乙状结肠造口术;3例经肛旁引流、局部冲洗后痊愈;余19例患者术后恢复良好。结论:吻合口漏是腹腔镜直肠癌根治术的严重并发症。减少术中直肠残端的闭合次数、注意吻合口两端肠管的血运情况、减缓术后过早排便等,从外科角度减少此并发症的发生。

Objective：To explore the causes,prevention and treatment of anastomotic leakage after laparoscopic radical resection for rectal cancer.Methods：The clinical data of 23 patients who underwent laparoscopic radical resection for rectal cancer from May 2011 to Jun.2012 were retrospectively analyzed.Results：Anastomotic leakage occurred in 4 cases,one of whom was concurrent with peritonitis and sigmoidostomy was performed.The other 3 cases were cured by perianal drainage and sectional washing.Nineteen cases well recovered after operation.Conclusions：Anastomotic leakage is a severe complication after laparoscopic radical resection for rectal cancer.Reducing the times of closure in the rectal stump,noticing the blood circulation of intestine near the anastomosis,and delaying the defecation time are measures to reduce rate of anastomotic leakage.