直肠前切除术后吻合口漏的高危因素及预防现状

High-risk factors and prevention of anastomotic leakage after anterior rectal resection

吻合口漏是直肠癌患者保肛术后最严重的并发症之一,其危险因素与患者、医疗、麻醉和手术等相关。吻合口漏重在预防,主要措施为术中检查吻合情况,保证吻合肠管血供、腹/盆腔引流、保护性造口和留置肛管。鉴别相关危险因素,降低吻合口漏的发生对改善患者结局有重要的临床意义。

Anastomotic leakage is one of the most serious complications after anus preserving operation in rectal cancer patients.Risk factors include patient-related factors,therapy-related factors,anesthesia and surgical-related factors.The main prevention measures include intraoperative examination of anastomosis,assurance of blood supply of anastomotic intestine,abdominal/pelvic drainage,protective stoma and transanal drainage.Identify risk factors and decrease the occurrence of anastomotic leakage are important for the improvement of patient outcomes.