吻合口支架预防直肠癌术后吻合口漏的应用观察

Application of intestinal stent in prevention of anastomotic leakage after rectal cancer operation

目的观察吻合口支架在预防直肠癌术后吻合口漏中的临床效果。方法采用回顾性队列研究方法。东莞东华医院普通外科于2017年6月至2019年8月对收治的48例低位直肠癌患者在行腹腔镜肿瘤根治术中放置吻合口支架以预防术后吻合口漏(放置支架组),回顾性总结其临床资料;并与同一手术组于2015年1月至2017年6月对59例施行同样手术、但术中未放置吻合口支架(未放支架组)患者的临床资料进行分析比较术后吻合口漏发生率及Wexner肛门功能评分。结果两组患者一般临床资料具有可比性,手术时间及术后Wexner肛门功能评分差异无统计学意义(均P>0.05),经术后1个月以上的近期随访,未放支架组吻合口漏发生率16.9%(10/59),放置支架组未出现吻合口漏,两组差异有统计学意义(P=0.002)。结论术中放置肠道支架可有效预防低位直肠癌术后吻合口漏的发生。

Objective To observe preventive effect of intestinal stent against anastomotic leakage after rectal cancer operation.Methods A retrospective cohort study was carried out.Clinical data of 107 patients with low rectal cancer undergoing laparoscopic radical resection from January 2015 to August 2019 were retrospectively analyzed.Intestinal stent was placed intraoperatively in 48 cases and was not placed in 59 cases.Postoperative Wexner score for anal function and incidence of anastomotic leakage were compared between patients with and without intstinal stent.Results There was no significant differences in age,distance between tumor and the anal verge,operative time and postoperative Wexner score for anal function between the two groups(all P>0.05).After a month of follow-up,the incidence of anastomotic leakage was 16.9%(10/59)in the non-stent group,while no anastomotic leakage was found in the stent group(P=0.002).Conclusion Placement of intestinal stent can effectively prevent anastomotic leakage after low rectal cancer surgery.