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目的探讨术中冲洗结肠及术后灌洗结肠对预防直肠癌低位吻合口瘘的手术方法和疗效。方法完成低位直肠前切除及淋巴结清扫后,远端结肠残端口接已消毒的洗衣机水管,切除阑尾将适号尿管从阑尾根部置入回盲部,用500ml生理盐水10~15瓶接一次性输液管至尿管持续开放冲洗结肠。直结肠吻合后用2条0.8~1cm引流管置在骶盆吻合周围行双管式持续灌洗骶盆时间约术后3~6d。结果改进组38例无发生吻合口瘘,经典组18例发生吻合瘘2例(11.1%)经统计学处理P<0.01。结论应用术中冲洗结肠及术后灌洗骶盆法可有效地预防直肠癌低位吻合口瘘的发生,其方法简便、安全、有效。
Objective To investigate the operative methods and curative effects of intraoperative irrigation of colon and postoperative lavage colon on prevention of low anastomotic fistula of rectal cancer. Method After the completion of low rectal resection and lymph node dissection, the distal end of the colon stump was disinfected washing machine water pipe, remove the appendix will be the number of catheter inserted into the ileocecal apical appendage, with 500ml saline 10 to 15 bottles of disposable The infusion tube to the catheter is continuously open to flush the colon. Straight colon anastomosis with two 0.8 ~ 1cm drainage tube placed around the sacral anastomosis double tube continuous lavage of the sacrococcygeal time after about 3 ~ 6d. Results In the improved group, no anastomotic fistula was found in 38 cases. In the classic group, 2 cases (11.1%) had anastomotic fistula in 18 cases, and the difference was statistically significant (P <0.01). Conclusion The operation of colon irrigation and postoperative lavage cisternaectomy can effectively prevent low anastomotic leakage of rectal cancer, the method is simple, safe and effective.