中低直肠癌全系膜切除及双吻合器吻合术后吻合口瘘的原因分析及防治

摘要

Objective To investigate the reasons for low colorectal cancer total mesorectal excision and double stapling anastigmatic fistula analysis and anti-Governance. Methods 47 cases of colorectal cancer patients from January 2009 to December 2013 in our hospital for surgical treatment of general surgery. All patients underwent a low total mesorectal excision and double stapling anatomizes, anastigmatic observed in patients fistula cases and analyzed their causes. Results 4 cases of postoperative anastigmatic fistula patients, 8.51%of the total number of patients, anastigmatic fistula time of 4 days to 10 days, the average time was(6.72 ± 1.69)days, including two cases of patients with clinical anastigmatic leakage conservative treatment, one case of anastigmatic leakage after temporary transverse colostomy patients were cured, one case of anastigmatic fistula in patients with anal fistula suture cure. Conclusion Anastigmatic leakage is the most common postoperative complications of low colorectal cancer total mesorectal excision and double stapling . By analyzing and taking appropriate preventive measures, the incidence of anastigmatic fistula can be reduced .%目的：分析中低位直肠癌全系膜切除及双吻合器吻合术后发生吻合口瘘的原因为防治措施提供参考。方法2009年1月～2013年12月普外科共收治47例中低直肠癌患者，所有患者均进行直肠全系膜切除及双吻合器吻合术，观察患者术后吻合口瘘的情况并分析其原因。结果术后4例患者出现吻合口瘘，占总患者数的8.51%，出现吻合口瘘的时间为4～10 d，平均为（6.72±1.69）d，其中2例吻合口瘘患者经临床保守治疗治愈，1例吻合口瘘患者经暂时性横结肠造口治愈，1例吻合口瘘患者经肛门瘘口缝合加保守治疗措施治愈。结论吻合口瘘是中低位直肠癌全系膜切除及双吻合器吻合术后常见的严重并发症之一，通过对吻合口瘘出现的原因进行分析，采取相应的防治措施，可降低吻口瘘的发生。