直肠癌术后吻合口瘘的防治进展

Progress in prevention and treatment of anastomotic leakage after surgery for rectal cancer

结直肠癌(colorectal cancer, CRC)是全球常见的恶性肿瘤之一,在我国其发病率和死亡率均居所有恶性肿瘤的第三位.其中直肠癌占所有CRC总发病率的60%-70%.随着对直肠癌发病机制和肿瘤转移机制的深入研究,以及手术技术方法的不断改进,中低位直肠癌保肛手术逐渐增多,患者生活质量虽然得到明显改善,但吻合口瘘仍是直肠癌保肛手术后最常见和最严重的并发症之一.研究显示直肠癌术后吻合口瘘的发生率为3%-21%,死亡率高达3%.因此,术前对患者进行全面检查,对危险因素进行综合分析,对于减少潜在吻合口瘘的风险,选择合适的手术方式和预防措施,从而有效的预防和减少吻合口瘘的发生有重要意义.本文对直肠癌术后吻合口瘘的危险因素和防治进展进行综述,以期能降低吻合口瘘的发生率.

Colorectal cancer(CRC)is one of the most common malignant tumors in the world,and its morbidity and mortality both rank third among all malignant tumors in China.Rectal cancer accounts for 60%-70%of cases of CRC.With the in-depth study of the pathogenesis of CRC and the mechanism of tumor metastasis,and the improvement of surgical techniques and methods,anal sphincter surgery for middle and low rectal cancer is increasing gradually.Although the quality of life of the patients improves significantly after anal sphincter preservation for rectal cancer,anastomotic leakage is still one of the most common and serious complications.Studies show that the incidence of anastomotic leakage after surgery for low rectal cancer is 3%-21%,and the death rate is up to 3%.Therefore,a comprehensive assessment of patients and analysis of risk factors before operation is of great significant for reducing the potential risk of anastomotic leakage and choosing surgical approach and appropriate preventive measures to prevent and reduce the occurrence of anastomotic leakage.In this paper,we summarize the recent research on anastomotic leakage after rectal cancer surgery in order to help other clinicians reduce the incidence of anastomotic leakage in clinical practice.