直肠癌保肛术中测定直肠残端微循环对预防吻合口瘘的应用

The application of microcirculation measurement of rectal stump in the prevention of anastomotic fistula in rectal cancer

目的:探讨直肠癌根治术中吻合时测定直肠残端微循环对于判定术后直肠吻合口瘘发生的意义。方法:选取直肠癌患者190例,对术中直肠吻合前测定直肠残端微循环与术后直肠吻合口瘘发生的关联进行ROC曲线统计分析。结论:行直肠癌根治术时,手术中直肠残端微循环测定对于手术中术式的选择,降低Ⅰ期保肛吻合术时吻合口瘘的发生具有重大临床意义。如术中测定直肠残端微循环值低于10.00(V)。建议继续修整直肠残端或行Hartmann术式,放弃吻合术术(Dixon术式)。为手术中术式的选择提供客观参考依据。

Objective: To investigate the significance of application of microcirculation measurement of rectal stump in the prevention of anastomotic fistula in rectal cancer. Methods: 190 cases of rectal cancer patients were selected and the correlation between the detection of the microcirculation of the rectal stump before intraoperative rectal anastomosis and the incidence of postoperative rectal anastomotic fistula was statistically analyzed by ROC curve. Conclusion: In colorectal cancer radical surgery, rectal stump microcirculation in determination for the choice of operation and reducing Ⅰ period to protect anal anastomosis from the occurrence of anastomotic fistula has important clinical significance. If the microcycle value of intraoperative measurement of rectal stump is lower than 10.00(V). It is suggested to continue to trim the rectal stump or perform Hartmann operation and give up the anastomosis(Dixon operation). Objective reference basis is provided for the selection of operative methods.