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目的探讨自制双套管持续负压吸引对低位直肠癌经腹前切除术后吻合口漏的防治效果。方法 2006年1月至2012年12月期间笔者所在医院施行了106例低位直肠癌经腹前切除术,均采用自制双套管持续负压吸引,回顾性分析其预防和治疗吻合口漏的效果。结果本组106例患者术后发生吻合口漏6例(5.66%),给予双套管持续滴注冲洗结合持续低负压吸引,同时给予全身抗感染、禁食、肠外营养或后期肠内营养处理。12~16 d(平均14 d)后患者的大便成型、冲洗液清亮,遂拔除引流管。其中1例为直肠阴道瘘,经保守治疗失败后行横结肠双腔造瘘术,于术后6周恢复,3个月后行造瘘口关闭术。结论低位直肠癌保肛手术应用自制双套管持续负压吸引技术后,吻合口漏的发生率较低;其还能有效控制盆腔感染,从而促进漏口愈合。
Objective To investigate the effect of self-made double cannula continuous negative pressure on the prevention and treatment of anastomotic leakage of low rectal cancer after abdominal resection. Methods From January 2006 to December 2012, the author performed 106 cases of low rectal cancer underwent antero-abdominal resection in our hospital. All patients underwent continuous negative pressure with self-made double cannula. The effect of prevention and treatment of anastomotic leakage was retrospectively analyzed . Results Sixty-six patients (5.66%) had anastomotic leakage in this group of 106 patients. The patients were given continuous infusion of double-cannula combined with sustained low-pressure suction while systemic infection, fasting, parenteral nutrition or post-enteral Nutritional treatment. After 12 to 16 days (average 14 days), the stool was formed and the irrigating solution was clear. The drainage tube was removed. One case of rectovaginal fistula, conservative treatment fails transverse colon double-chamber ostomy, 6 weeks after the restoration, 3 months after the line of stoma closure. Conclusions The incidence of anastomotic leakage is low when using self-made dual-cannula continuous negative pressure suction technique for anorectal surgery of low rectal cancer. It can also effectively control the pelvic infection and promote the healing of the leakage.