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目的探讨低位直肠癌前切除术双吻合器应用吻合口漏因素分析及预防措施。方法对2005-01-2010-12209例低位直肠癌前切除双吻合器应用18例发生吻合口漏患者资料回顾分析。结果 18例(8.6%,18/209)术后出现吻合口漏,15例于术中采取预防性造瘘仍有2例发生吻合口漏,未经特别处理自愈;另外16例中11例经保守痊愈,5例行横结肠造瘘术,吻合口治愈后二期还纳治愈。结论双吻合器应用低位直肠癌前切除发生吻合口漏原因与直肠解剖学特点、患者性别、全身状况、手术医生使用吻合器熟练情况、围手术期处理、术前放化疗等密切相关。围手术期采取相应的有效措施可降低吻合口漏发生。
Objective To investigate the factors of anastomotic leakage in preoperative resection of low rectal cancer and its preventive measures. Methods A retrospective analysis of 18 cases of anastomotic leakage in 2005-01-2010-12209 cases of low rectal cancer precancerous double stapler was performed. Results Eighteen patients (8.6%, 18/209) had anastomotic leakage after surgery. Among the 15 patients who received prophylactic fistula during operation, 2 patients still developed anastomotic leakage without any special treatment. In the other 16 patients, 11 patients After conservative healing, 5 cases of transverse colostomy, anastomotic cured after two. Conclusions The reason of anastomotic leakage in the preoperative resection of low rectal cancer with double stapling is closely related to anatomic characteristics of the rectum, gender and general condition of the double stapler, skilled use of the stapler by the surgeon, perioperative management and preoperative chemoradiation. Perioperative take appropriate effective measures to reduce the occurrence of anastomotic leakage.