超低位直肠前切除吻合口瘘的诊治体会

Diagnosis and treatment of anastomotic fistula of ultra-infraversion Dixon

目的 :探讨低位直肠癌超低位直肠前切除吻合口瘘的原因、诊断及预防措施。方法 :复习 9例超低位直肠前切除吻合口瘘的临床资料并结合文献进行分析。结果 :早期瘘 (<5天 ) 1例 ,中期瘘 (7～ 12天 ) 8例 ,1例行横结肠造口 ,8例行非手术治疗均治愈 ,非手术治疗时间平均为 18(14～ 32 )天。结论 :吻合口瘘主要与全身营养状况、肠道准备情况、手术操作技巧、吻合口血供、张力及引流是否通畅有关。为减少吻合口瘘的发生 ,应做好充分的肠道准备 ,确保吻合口无张力及良好的血供 ,术后保持骶前引流通畅 。

Objective:To probe into the cause and diagnosis of anastomotic fistula for ultra infraversion Dixon,and the measures to prevent it.Methods:The clinical data of 9 patients with anastomotic fistual of ultra infraversion Dixon were analyzed retrospectively.Results:One patient underwent early fistula operation(less than 5 days),8 patients underwent middle stage fistula operation(7 to 12 days) and 1 patient underwent temportay transversostomy for general peritonitis.Eight patients underwent nonspecific treatment.The mean time for nonspecific treatment was 18 days after anastomotic fistula.Conclusions:Anastomotic fistula is related to nutrition,enteric preparation,operative technique,blood supply and tention,and drainage.In order to reduce the occurrence of anastomotic fistula,adequate enteric preparation should be made to ensure that the anastomosis has no tention,there is a good blood supply and a unobstructed dranage tube of sacralis anterior.The general condition of the patients should be paid attention to. [