摘要
目的探讨直肠癌超低位前切除术后吻合口漏防治的防治措施的效果；方法回顾性分析2003年1月-2008年11月行直肠癌超低位前切术的126个病例，32例行预防性回肠造口（A组），94例未施行预防性回肠造口，其中51例经腹腔放置引流（B组），43例经会阴骶前引流（C组）比较各组瘘的发生率，腹膜炎的发生率，瘘发生后的处理方式，平均愈合时间。结果A组无一例发生吻合口瘘，B组12例发生吻合口瘘，吻合口瘘发生率为23.51％，其中6例出现腹膜炎，瘘发生后7例行回肠造口术，平均愈合时间为29天C组3例发生吻合口瘘，吻合口瘘发生率为6.97％，无腹膜炎，均经冲洗引流后愈合，平均愈合时间为13天。结论回肠行预防性回肠造口能有效预防吻合口漏。
Objective： To investigate the efficacy of prevention and cure of anastomotic leakage after operation of ultralow anterior resection for rectal carcinoma. Methods： Retrospective study was employed to analyze the clinical data of 126 patients received operation of ultra-low anterior resection for rectal carcinoma from january 2003 to november 2008 ,in which 32 patients received the operation of prophylactic ileostomy （group A）, 51 patients with abdominal cavity drainage （group B） ,43 patients with perineum drainage （group C） among 94 patients without operation of prophylactic ileostomy. The incidence rates of anastomotic fistula and peritonitis , the methods of teatment and the average cure time of anastomotic fistula were compared between different groups. Results： There was no anastomofic fistula in group A,the incidence rates of anastomotic fistula in group B was 23. 53%（12 patiens,among them 6 patients with peritonitis,7patients received ileostomy after fistula） and in group C was 6. 97%（no peritonitis,the patients had been cured by washing the drainage tube.）, the average cure time of anastomotic fistula in rgoupA was29days , while that in rgoupB was 12 days. Conclusion：The operation of prophylactic ileostomy can prevente anastomotic fistula effectively and the drainage by perinaeum plays a very important role in prevention and treatment of anastomotic fistula after operation of ultra-low anterior resection for rectal carcinoma
关键词
直肠癌
手术
吻合口漏
Rectal cancer
Operation
Anastomotic leakage
