直肠癌术后吻合口瘘的防治

Summary of rectal cancer anastomotic fistula treatment experience

目的：探讨直肠癌术后吻合口瘘产生的原因及治疗方法、预防措施。方法选取行经腹直肠癌根治术（Dixon 术）患者208例的临床资料，其中13例发生吻合口瘘，进行回顾性分析，总结经腹直肠癌术后吻合口瘘发生的原因、治疗方法与预防措施。结果13例患者全部痊愈出院，出院后随访6个月均无肠粘连梗阻、吻合口狭窄、盆腔脓肿等症状。结论术前掌握经腹直肠癌根治术后吻合口瘘发生的危险因素，积极做好术前准备，掌握精细解剖和手术要点是预防吻合口瘘的要点。

Objective To investigate the cause of postoperative colorectal cancer anastomotic fistula,the treatment and prevention measures.Methods 2007 -2014,The department of General surgery in Qingdao Municipal hospitals for abdominal colorectal cancer resection（Dixon surgery）were 208 cases,including 13 cases of anastomotic leakage occurred.Retrospective summarized the cause,treatment and preventive measures of abdominal colorectal cancer anastomotic fistula.Results All of 13 patients were discharged,and had no adhesions obstruction,anastomotic stricture,pelvic abscess and other symptoms following -up 6 months after discharge.Conclusion Grasping preopera-tive risk factors of abdominal colorectal cancer for anastomotic fistula,actively preoperative preparation,and master of fine anatomical and surgical point are the main points of the prevention of anastomotic leakage.