低位直肠癌保肛术后吻合口漏的原因及防治现状

Causes and Current Situations of Prevention and Treatment for Anastomotic Leakage after Low Anterior Resection for Rectal Cancer

目的分析低位直肠癌保肛术后吻合口漏的常见原因,以探索更好的预防及治疗策略。方法采用文献复习的方法对吻合口漏的定义、常见原因、防治现状等相关文献进行综述。结果目前直肠癌是我国常见恶性肿瘤之一,其中低位直肠癌约占2/3。低位直肠癌保肛手术已成为首选的术式,但保肛术后吻合口漏仍是最严重和常见的并发症之一。通过改善患者一般状况,提高手术技巧,规范化治疗等可有效减少吻合口漏的发生。结论术前合理评估患者基本状况,规范化并个体化治疗,有助于降低吻合口漏的发生率以及改善患者临床结局。

Objective To analyze the common reasons of anastomotic leakage following sphincter preservation for rectal cancer, and to explore the better prevention and treatment strategies. Method The related literatures of the definition, common causes, and prevention and treatment status of anastomotic leakage were reviewed. Results Currently rectal cancer was one of common malignant tumors, including about 2/3 low rectal cancer. Recently, sphincter preserving surgery had become the preferred surgical procedure. However, the incidence of anastomotic leakage keeping in higher was still the most serious and common complications. Through improving the general condition of the patients, improving surgical techniques, and standardized treatment could effectively reduce the incidence of anastomotic leakage. Conclusion Reasonable preoperative assessment for the basic situation of patients with rectal cancer, standardized and individualized treatments, contribute to reduce incidence of anastomotic leakage and improve clinical outcomes in patients with low rectal cancer.