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目的 探讨预防梗阻性左半结肠癌一期切除吻合术后吻合口漏发生的新方法。方法 将 2 15例梗阻性左半结肠癌接受术中结肠灌洗和一期切除吻合等处理的患者随机分为两组。双管引流组术中经肛门放置结肠腔内双管引流。扩肛组术中不放置肠腔内引流管 ,术后定时扩肛。对两组患者术后腹腔脓肿和吻合口漏发生率进行对比分析。结果 腹腔脓肿和吻合口漏发生率双管引流组分别为 3 1% ( 4 13 0 )和 3 8% ( 5 13 0 ) ,扩肛组分别为 10 6% ( 9 85 )和 12 9% ( 11 85 ) ,两组腹腔脓肿和吻合口漏发生率之差异均有显著性意义 (P <0 0 5 )。结论 结肠腔内置管引流具有预防性结肠“内造瘘”、减压减张、冲洗洁净和持续性扩肛作用 ,能有效地预防和减少梗阻性左半结肠癌一期切除吻合术后吻合口漏的发生。
Objective To explore a new method of prevention of anastomotic leakage after primary resection and anastomosis in patients with obstructive left colon cancer. Methods Two hundred and fifty-one patients with obstructive left colon cancer undergoing colonic irrigation and one-stage resection and anastomosis were randomly divided into two groups. Double drainage group by intraoperative anal placed colon double lumen drainage. In the group of anorectal surgery, drainage of the intestine was not performed and the anus was regularly extended after operation. The incidence of postoperative abdominal abscess and anastomotic leakage in both groups were compared. Results The incidences of abdominal abscess and anastomotic leakage in the two groups were 31% (4 13 0) and 38% (5 13 0) respectively, while those in the anal group were 10 6% (9 85) and 12 9% 11 85). There was significant difference between the two groups in the incidence of abdominal abscess and anastomotic leakage (P <0.05). Conclusions The drainage of the colon lumen with prophylactic colon “internal fistula”, decompression and decompression, rinse clean and persistent anal effects, can effectively prevent and reduce obstruction in the first stage of anastomotic resection and anastomosis Leakage occurred.