摘要
为探讨直肠癌Dixon术后吻合口漏的相关因素及防治措施，对2008-2012年于我科行Dixon术治疗的240例直肠癌患者资料进行回顾性分析。结果显示，本组术后发生吻合口漏25例（10．4％）。吻合口漏的发生率与患者性别、年龄、吻合技术、肿瘤Dukes分期无关，P〉O．05；与有无伴发病、肠梗阻及吻合口位置、肿瘤至肛缘距离有关，P〈0．05。25例吻合口漏患者经保守治疗均获痊愈。结果表明，直肠癌Dixon术后发生吻合口漏的原因是多方面的，术前应充分评估，尤其是针对有严重伴发病、肠梗阻者及肿瘤位置低、估计需腹膜外吻合者，要严格筛选病例；术中应精细操作，加强围手术期管理。一旦发现吻合口漏，应尽早制定适宜的治疗方案，促进吻合口漏尽快愈合，一般经保守治疗可治愈。
This paper discusses the prevention ~ treatment measures and relevant factors of anastomosis leakage after Dixon procedure for rectal carcinoma. Author retrospectively analyzed the data of 240 patients with rectal carcinoma who had been subjected to Dixon procedure in author＇s department from 2008 to 2012 yr. As results,in this study 25 cases（10.4~） were suffered from postoperative anastomosis leakage and cured through conservative therapy;the incidence was not related with patient＇s sex and age,anastomosis skill,and Dukes staging of neoplasms（ P ）0.05）,but was related with following factors such as the distance between neoplasms and anal edge, the sites of anastomosis, as well as with or without associated diseases and intestinal obstruction（ P〈0.05）. Results show that the causes resulting in stoma leakage are multiple aspects and should be enough estimated preoperatively, specially for those with severe associated diseases and intestinal obstruction as well as lower neoplasms,case selection should be strict;also,intraop- erative manipulation be careful, and perioperative management be strengthened; a anastomosis leakage is once discovered,it should be as early as possible making appropriate treatment project, so that promoting healing of anastomosis leakage as fast as possible;generally, conservative therapy can cure it.
出处
《中国肛肠病杂志》
2013年第12期17-19,共3页
Chinese Journal of Coloproctology
关键词
直肠癌
DIXON手术
吻合口漏
Rectal carcinoma
Dixon procedure
Anastomosis leakage
