腹腔镜低位直肠前切除术后吻合口漏的原因及预防

doi:10.3969/j.issn.1009-976X.2015.06.011

摘要/Abstract

摘要： 【摘要】目的探讨腹腔镜下低位直肠前切除术后吻合口漏的原因和预防措施。方法回顾性分析2014年5月至2015年6月253例低位直肠癌患者行腹腔镜低位直肠前切除术的临床资料。结果 253例患者手术均获成功,无一例死亡。其中15例患者(5.9%)发生了术后吻合口漏,1例因腹膜炎行腹腔镜再手术并行回肠末端造口,14例经腹膜外骶前引流、局部冲洗、抗感染及肠外营养支持等保守治疗后痊愈;其余患者恢复良好。腹腔镜低位直肠前切除术发生术后吻合口漏的原因主要与术后肠管血运不良、吻合口张力较大以及直肠双吻合技术缺陷有关。结论腹膜外骶前置管引流是是治疗术后吻合口漏的有效措施。

关键词: 腹腔镜手术, 低位直肠前切除术, 吻合口漏

Abstract: 【Abstract】〓Objective〓To investigate the causes and prevention of anastomotic leakage after laparoscopic low rectal anterior resection. Methods〓A retrospective data from May 2014 to June 2015 were analyzed in 253 cases of low rectal cancer patients undergoing laparoscopic low rectal anterior resection. Results〓The operation in 253 cases was successful, and no one transferred to open operation. Fifteen cases (5.9%) had postoperative anastomotic leakage,.and one case of peritonitis were treated by laparoscopic reoperation for the terminal ileum ostomy,.and the other 14 cases were cured by conservative treatment by the extraperitoneal presacral drainage, local irrigation, anti-infection and parenteral nutrition..The anastomotic leakage for laparoscopic low rectal anterior section was associated with postoperative intestinal blood supply adverse,.large anastomotic tension and good double stapling technique. Conclusion〓The extraperitoneal sacral front tube drainage is an effective measures for treatment of postoperative anastomotic leakage.

Key words: Anastomotic leakage, Low rectal anterior resection, Laparoscopic operation

中图分类号:

R657.1

段建平龚瑾李霄阳. 腹腔镜低位直肠前切除术后吻合口漏的原因及预防[J]. 岭南现代临床外科, 2015, 15(06): 686-690.

Duan Jianping, Gong Jin, Li Xiaoyang. Causes and prevention of anastomotic leakage after laparoscopic low rectal anterior resection[J]. Lingnan Modern Clinics in Surgery, 2015, 15(06): 686-690.

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