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目的探讨低位直肠癌保肛术后吻合口漏的原因、预防及处理方法。方法对低位直肠癌全系膜切除低位吻合手术后吻合口漏的发生及治疗情况进行回顾性分析。对吻合口漏的患者采用保守治疗(经腹部引流冲洗和会阴引流管引流)及手术治疗。结果术后发生吻合口漏18例。采用保守治疗16例,行手术治疗2例,均痊愈出院。结论低位直肠癌保肛术后吻合口漏应以预防为主,满意的术前准备,掌握低位直肠癌保肛术要点并注重操作细节是预防吻合口漏的关键。恰当引流管放置以利于充分引流对吻合口漏的治愈具有重要意义。
Objective To investigate the causes, prevention and treatment of anastomotic leakage after anus-protection in low rectal cancer. Methods The incidence and treatment of anastomotic leakage after low total anastomosis for low rectal cancer were retrospectively analyzed. Conservative treatment (abdominal drainage and perineal drainage tube drainage) and surgical treatment were used for patients with anastomotic leakage. Results Postoperative anastomotic leakage occurred in 18 cases. Sixteen patients were treated conservatively and 2 were treated surgically. All were cured and discharged. [Conclusion] Anastomotic leakage after anus-preserving surgery for low rectal cancer should be mainly prevention. Satisfactory preoperative preparation, mastering the main points of low rectal cancer anus-preservation and paying attention to operation details are the key to prevent anastomotic leakage. Proper drainage tube placement to facilitate adequate drainage of the anastomotic leakage is of great significance.