远侧直肠闭合端残角切除对直肠癌根治术术后吻合口瘘发生的影响

Effect of residual angle resection at distal rectum closed end after eradicative resection of rectal cancer

目的探讨远侧直肠闭合端残角切除对直肠癌根治术后吻合口瘘发生的影响。方法收集腹腔镜下直肠癌根治术患者109例,按照术中处理远侧直肠闭合端的方式分为观察组(远侧直肠闭合端残角切除,52例)和对照组(57例),比较两组术后吻合口瘘发生情况。结果观察组吻合口瘘发生率低于对照组(1.92%vs.12.28%)(P<0.05)。共有8例发生吻合口瘘;其中,1例行横结肠造口术,7例均经通畅引流、持续骶前冲洗、营养支持和抗感染等综合治疗。所有患者瘘口均愈合良好。结论切除远侧直肠闭合端残角可有效减少吻合口瘘的发生。

Objective To explore the effect of residual angle resection at distal rectum closed end on anastomotic leakage after eradicative resection of rectal cancer.Methods With laparoscope,eradicative resection of rectal cancer was performed in 109 patients,who were divided into group A（underwent residual angle resection at distal rectum closed end,52cases）and C（did not as the control,57cases）.Occurence of anastomotic leakage after operation was compared between two groups.Results Incidence rate of anastomotic leakage in group A was lower than that in group C（1.92%vs.12.28%）（P〈0.05）.Of 8patients with postoperative anastomotic leakage,one case underwent transverse colostomy and seven cases were treated comprehensively including unobstructed drainage,continuous presacral washing,nutrition support and anti-infection,who all healed well after treatments.Conclusion Residual angle resection at distal rectum closed end can effectively reduce the occurrence of postoperative anastomotic leakage.