目的 探討低位直腸癌雙吻合器保肛手術(shù)后吻合口漏的預(yù)防。
方法 回顧性分析2000年5月至2005年5月我院肛腸外科行雙吻合器保肛手術(shù)的78例低位直腸癌患者的資料。
結(jié)果 所有病例應(yīng)用雙吻合器進(jìn)行直腸閉合并吻合成功,術(shù)后切緣病理檢查均未見癌細(xì)胞浸潤(rùn),無吻合口漏及手術(shù)死亡。隨訪73例(93.6%),隨訪時(shí)間9~65個(gè)月,平均35個(gè)月。盆腔復(fù)發(fā)2例(2.6%),腹腔廣泛轉(zhuǎn)移1例(1.3%),肝臟轉(zhuǎn)移7例(9.0%),吻合口局部復(fù)發(fā)1例(1.3%,術(shù)后11個(gè)月再次行Miles術(shù))。
結(jié)論 雙吻合技術(shù)為低位直腸癌患者提供更多的保肛機(jī)會(huì),使用得當(dāng)可有效預(yù)防吻合口漏的發(fā)生。
引用本文: 張宏,陳春生,喬雷,叢進(jìn)春,馮勇,劉恩卿. 低位直腸癌雙吻合器保肛手術(shù)后吻合口漏的預(yù)防策略. 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(1): 89-90. doi: 復(fù)制
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- 1. Griffen FD, Knight CD, Whitaker JM. et al. The double stapling technique for low anterior resection. Results, modifications, and observations [J]. Ann Surg, 1990; 211(6)∶745.
- 2. 邱輝忠. 雙吻合技術(shù)在低位直腸腫瘤手術(shù)中的應(yīng)用 [J]. 中國(guó)實(shí)用外科雜志, 2005; 25(3)∶139.
- 3. 郁寶銘, 李東華, 鄭民華, 等. 直腸系膜全切除在雙吻合器低位前切除術(shù)中的意義 [J]. 中華外科雜志, 2000; 38(7)∶496.
- 4. 黃偉民, 李洪濤, 楊明, 等. 直腸癌雙吻合器保肛術(shù)吻合口漏的預(yù)防和治療(附81例報(bào)告) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005; 12(1)∶40.
- 5. Fu CG, Muto T, Masaki T. Results of the double stapling procedure in colorectal surgery [J]. Surg Today, 1997; 27(8)∶706.
- 6. Sato H, Maeda K, Hanai T, et al. Modified double-stapling technique in low anterior resection for lower rectal carcinoma [J]. Surg Today, 2006; 36(1)∶30.
- 7. Asao T, Kuwano H, Nakamura J, et al. Use of a mattress suture to eliminate dog ears in double-stapled and triple-stapled anastomoses [J]. Dis Colon Rectum, 2002; 45(1)∶137.
- 8. Roumen RM, Rahusen FT, Wijnen MH, et al. “Dog ear” formation after double-stapled low anterior resection as a risk factor for anastomotic disruption [J]. Dis Colon Rectum, 2000; 43(4)∶522.