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目的探讨腹腔镜直肠癌根治保肛术后吻合口瘘的危险因素以及预防措施。方法选取2014年1月—2016年10月收治的行腹腔镜直肠癌根治保肛术的直肠癌患者84例,设定为观察组,选择同期行开腹手术治疗的直肠癌患者50例,设定为对照组。对比两组术后吻合口瘘发生情况及危险因素,并总结相应的预防措施。结果两组患者中,术前是否存在肠梗阻、性别、吻合口位置等对吻合口瘘发生率的影响差异具有统计学意义(P<0.05);观察组在吻合口位置位于腹膜反折以下的吻合口瘘发生率高于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜直肠癌根治保肛术后吻合口瘘的危险因素主要为术前是否存在肠梗阻、性别和吻合口位置,而吻合口位置位于腹膜反折以下的吻合口瘘发生率腹腔镜手术组高于开腹手术组。
Objective To investigate the risk factors and preventive measures of anastomotic leakage after radical anal sphincter preservation in laparoscopic rectal cancer. Methods From January 2014 to October 2016, 84 patients with rectal cancer undergoing laparoscopic radical rectal cancer preservation surgery were enrolled. A total of 84 patients with rectal cancer who underwent laparotomy in the same period were selected as study group. As a control group. The incidence and risk factors of anastomotic fistula were compared between the two groups, and the corresponding preventive measures were summarized. Results There was significant difference in the incidence of anastomotic fistula (P <0.05) between preoperative and postoperative patients with intestinal obstruction, gender and anastomotic location in the two groups. The observation group was located below the peritoneal fibular fold in the anastomotic site Anastomotic fistula incidence was higher than that of the control group, the difference was statistically significant (P <0.05). Conclusions The main risk factors for anastomotic leakage after anastomosis of laparoscopic rectal cancer include the presence of intestinal obstruction, sex and anastomotic site, and the incidence of anastomotic leakage below the peritoneal anterior fold in laparoscopic rectal cancer laparoscopic surgery group Higher than the open surgery group.