三腔引流管肠腔内引流联合腹膜外引流预防低位直肠癌吻合口瘘的临床研究

Research in Three- coeliac Tube Internal Drainage Combined with Extraperitoneal Drainage to Prevent Low Rectal Cancer Anastomotic Fistula

目的：探讨三腔引流管肠腔内引流联合腹膜外引流预防低位直肠癌吻合口瘘的应用价值。方法：采集2010年1月～2015年3月河北北方学院附属第三医院普通外科同一手术组实施的221例数据完整的开腹直肠癌低位前切除术患者的临床资料，随机分为研究组和对照组，其中128例采用三腔引流管肠腔内引流联合腹膜外引流法（研究组），93例经腹腔放置常规引流管（对照组）。总结分析两组患者的手术时间、术后吻合口瘘发生率及术后二次手术干预率。结果：与对照组相比，研究组术后吻合口瘘发生率及术后手术干预率好于对照组，差异有显著性；但手术时间、术后恢复控制大便时间差异无显著性。两组患者均无严重并发症发生。结论：三腔管腔内引流并联合腹膜外引流法能降低直肠癌低位前切除术后吻合口瘘发生率，可以提高吻合口瘘保守治疗成功率，降低吻合口瘘手术干预的比率，提高患者生活质量。

OBJECTIVE： To evaluate the application value of three - coeliac tube internal drainage combined with extraperitoneal drainage to prevent low rectal cancer anastomotic fistula. METHODS： From January 2010 to March 2015, the clinical data of 221 cases with lower rectal cancer in the third hospital were analyzed retrospectively. All of the cases were randomly divided into research group （n = 128） and control group （n = 93 ）. The research group of 93 cases accepted abdominal conventional drainage. The mean operative duration, incidence of anastomotic leakage rates and reoperation rates between the two groups were analyzed comparatively. RESULTS： The anastomotic leakage rates and reoperation rates were less in research group. There was significant difference between two groups. The operative duration and control defecate time were very close. There was no significant difference between the two groups. No serious complications were occurred in two groups. CONCLUSION ： Three - coeliac tube internal drainage combined with extraperitoneal drainage can reduce the incidence of anastomotic fistula after low rectal cancer resection, improve the conservative treatment success rate of anastomotic fistula and increase living quality of the patients.