中低位直肠前切除术后吻合口瘘原因分析及预防性造瘘的必要性.pdf

12 目录中文摘要...............................................................................3 英文摘要...............................................................................4 正文.......................................................................................5 引言.................................................................................5 资料与方法.....................................................................5 结果................................................................................7 讨论................................................................................10 参考文献..............................................................................17 致谢......................................................................................19 综述......................................................................................20 3 中低位直肠前切除术后吻合口瘘原因分析及预防性造瘘的必要性摘要:目的:探讨中低位直肠癌直肠前切除切除术后吻合口瘘的原因及中低位直肠前切除术后是否需要常规行预防性造瘘。方法:对2010年1月至2012年10月收治中低位直肠癌在我科行直肠前切除术(开放手术及腹腔镜手术)150例患者的临床资料进行回顾性分析和总结。结果:本组共有18例(%)在术后3-13天发生吻合口瘘,其中男性80例,有14例发生吻合口瘘,女性70例,有4例吻合口瘘; 低位(≤5)有65例,吻合口瘘12例,中位(>5)85例,吻合口瘘6例;术前肠梗阻4例,吻合口瘘1例,腹腔镜组86例,吻合口瘘9例,开放组64例,吻合口瘘9 例;18例吻合口瘘病例中,8例原有行预防性造瘘,均在保守治疗后痊愈,10例未行预防性造瘘,有6例在保守治疗后痊愈,4例经保守治疗无效后改行手术治疗后痊愈。结论:吻合口瘘的发生主要与性别、肿瘤位置高低、低蛋白血症程度以及肿瘤分期等因素有关,是否选择预防性造瘘应根据高危因素,个体化、选择性行预防性肠造瘘。关键词:直肠癌;直肠前切除术;吻合口瘘;预防性造瘘 4 In low rectal anastomosis after total root cause analysis and preventive colostomy necessity 【Abstract】Objective: To investigate rectum in low rectal anterior resection anastomotic fistula after anterior resection and whether you need regular preventive colostomy. Methods: For low rectal cancer (- from the anal 2-8cm) in our hospital clinical data of rectal anterior resection(open surgery and laparoscopic surgery )in 150 patients were retrospectively analyzed and summarized. Results: in this group, there were 18 cases (12%) in 3-13 days postoperative anastomotic which 80 were male, 14