低位直肠癌术后吻合口瘘防治的研究进展

The progress of prevention and treatment of anastomotic leakage after low anterior resection for rectal cancer

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.低位直肠癌保肛术已成为首选的术式,但术后吻合口瘘仍是最严重和常见的并发症之一.直肠癌术后吻合口瘘重在预防,通过术前改善全身情况、提高手术技能、确保在无张力状态下吻合和吻合口血供保护,有助于降低吻合口瘘的发生率以及改善病人临床结局.对于已经发生吻合口瘘的病人,足量的营养支持及可靠的引流是取得保守治疗成功的关键.本文复习国内外最新文献,并结合临床实践,对吻合口瘘的定义、临床表现、诊断、影响因素、预防及治疗进展作一阐述.

Cancer is one of common malignant tumors in our country, and the low rectal cancer accounts for about 2/3. Recently, sphincter preserving surgery had become the preferred surgical pro- cedure However, the incidence of anastomotic leakage keeping in higher is still one of the most seri- ous and common complications. Prevention of the anastomotic leakage of anal preserving surgery for rectal cancer is very important. Improving the general conditions of the patients, improving surgical techniques, making sure anastomosis without tension, and protecting the anastomotic blood supply can effectively reduce the incidence of anastomotic leakage and improve clinical outcomes in patients with low rectal cancer. For patients with anastomotic leakage, plenty of nutritional support and reliable drainage are the key to success of conservative treatment. This paper introduces the latest progress in the definition, clinical manifestations, diagnosis, treatment and prevention for anastomotic leakage.