腹腔镜结直肠手术消化道重建中吻合失败及对策

Anastomotic failure and countermeasures in digestive tract reconstruction of laparoscopic colorectal surgery

结直肠手术消化道重建中吻合失败所致吻合口漏是结直肠外科最严重的并发症之一。吻合口漏不仅对病人围手术期死亡率有实质性危害,也对术后器官功能恢复、肿瘤学结局、病人长期生存有不良影响。目前,对于结直肠吻合口漏的定义、危险因素、预防措施仍缺乏共识。多项高质量研究正在进行,将为吻合口漏的防治提供高级别证据。为降低腹腔镜结直肠手术中吻合口漏发生率和病死率,临床医生需识别并调整可控性危险因素、积极干预高风险病人,同时避免不必要的过度处理。应用多学科、多模式的临床策略或可降低结直肠手术的吻合口漏发生率和病死率。

The incidence of anastomotic leakage caused by failed anastomosis in colorectal surgery is one of the most serious complications in colorectal surgery.Anastomotic leakage not only increases the perioperative mortality of patients but also has a negative impact on postoperative organ function recovery,oncological outcome,and long-term survival of patients.At present,there is still no consensus on the definition,risk factors,and preventive measures of colorectal anastomotic leakage.A number of high-quality studies are underway,which will provide high-level evidence for the prevention and treatment of anastomotic leakage.To reduce the incidence of anastomotic leakage and mortality in laparoscopic colorectal surgery,clinicians need to identify and adjust controllable risk factors and actively intervene in highrisk patients while avoiding unnecessary overtreatment.The application of multidisciplinary and multimodal clinical strategies is expected to reduce the incidence and mortality of anastomotic leakage in colorectal surgery.