双吻合术预防低位直肠癌术后吻合口漏的临床研究

Double stapling technique anastomosis in the prevention of anastomotic leakage after surgery for lower colon rectal cancer

目的探讨双吻合术对预防低位直肠癌手术后吻合口漏的作用。方法选取2015年4月至2016年4月于本院行手术治疗的直肠癌患者74例为研究对象,随机分为治疗组和对照组,每组各37例。治疗组采用弧形切割闭合器行双吻合术,对照组行单吻合术,比较两组患者术后吻合口的一般情况。结果治疗组控制排便功能和排便功能保留率分别为97.30%、100%,对照组为81.08%、98.30%,两组之间差异无统计学意义(%0.05)。治疗组吻合口漏发生率为0.00%,对照组为16.22%,治疗组明显低于对照组(P<0.05)。治疗组并发症发生率为5.40%,对照组为32.43%,治疗组明显低于对照组(P<0.05)。结论切割闭合远端直肠的双吻合术可以有效减少低位直肠癌术后患者吻合口漏的发生率,减少吻合口并发症的发生,并且可有效保留患者的肛门功能,有较高的临床应用价值。

Objective To investigate the effect of double stapling technique anastomosis in the prevention of anastomotic leakage after surgery for lower colon rectal cancer. Methods 74 patients with lower rectal cancer who underwent surgery in our hospital from April 2015 to April 2016 were recruited and randomly assignedto treatment group and control group by random number table method, with 37 patients in each group.The treatment group reeeiveddouble stapling technique？anastomosis and the control group received traditional single stapling anastomosis.Comparison inanal function and occurrence of anastomotic leakage after operation was perform between the two groups. Results The retention rate of bowel movement anddefecation function was 97.30% and 100%, respectively,in the treatment group. The corresponding figures in the control group were 81.08%and 98.30%, respectively, with no between-group difference （P〉 0.05）. There was no occurrence of anastomotic leakage in the treatment group, which was significantly lower than that in the control group （16.22%, P〈 0.05）.The incidence rate of complications in the treatment group was 5.40%,which was significantly lower than in the control group was （32.43%, P〈 0.05）. Conclusions Double stapling technique anastomosiscan effectively reduce the incidence of anastomotic leakage after operation in patients with low rectal cancer and reduce the incidence of complications.h can also effectively retain patient＇s anal function.h has high clinical potential.