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目的:探讨直肠癌低位/超低位前切除术中预防吻合口瘘的操作技巧。方法:对我院2008年1月至2014年12月期间直肠癌行低位/超低位前切除术后出现吻合口瘘患者的临床资料和术中操作技巧进行分析总结。结果:35例患者术后出现吻合口瘘,吻合口瘘发生率4.26%(35/822);吻合口瘘发生时间为术后4天~25天(中位8天)。13例(37.1%)患者行肠造瘘手术,22例(62.9%)行局部置管冲洗引流,配合全身营养支持治愈,无死亡病例。结论:注重术中操作技巧,确保肠段的血供和无张力,施行高质量的吻合是预防直肠癌低位/超低位前切除术后吻合口瘘的关键。
Objective: To explore the technique of preventing anastomotic fistula in anterior resection of low rectal cancer. Methods: The clinical data and operative skills of patients with anastomotic fistula who underwent anterior resection of low / super low rectum in our hospital from January 2008 to December 2014 were analyzed and summarized. Results: Anastomotic fistula was found in 35 cases. The incidence of anastomotic fistula was 4.26% (35/822). Anastomotic fistula occurred 4 days to 25 days after operation (median 8 days). Thirteen patients (37.1%) underwent intestinal ostomy, and 22 patients (62.9%) underwent local catheter flushing and drainage, and were cured with systemic nutrition support without death. Conclusion: It is the key to prevent the anastomotic fistula after low / ultra low rectal resection of rectal cancer by paying attention to intraoperative operative skills, ensuring the blood supply and tension-free of the intestine and implementing high quality anastomosis.