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【目的】探讨直肠全系膜切除术(TME)后吻合口漏的治疗对策和教训。【方法】回顾性分析两所医院近5年余701例距肛缘4-12 cm的中低位直肠癌行TME技术的直肠前切除术的资料。【结果】术后吻合口漏发生率6.3%(44/701),6例(0.86%,6/701)因中毒性休克死亡。4例(0.57%,4/701)因骶前引流管放置时间过长,致肛旁窦道不愈合。【结论】TME术后吻合口漏时,应保持引流管通畅,冲洗引流管应慎重;骶前引流管放置时间不宜过长。
[Objective] To investigate the therapeutic strategies and lessons of anastomotic leakage after total mesorectal excision (TME). 【Methods】 A retrospective analysis was performed on the preoperative rectal resection of 701 patients with middle and low rectal cancer 4-12 cm from the anal margin using TME technique in the past 5 years. 【Results】 The incidence of postoperative anastomotic leakage was 6.3% (44/701). 6 patients (0.86%, 6/701) died of toxic shock. In 4 cases (0.57%, 4/701), the anterior peritoneal sinus did not heal due to the long drainage tube placed before the fistula. [Conclusion] When the anastomosis leakage occurs after TME, the drainage tube should be kept unobstructed, and the irrigation drainage tube should be cautious; the drainage tube before the fistula should not be placed in too long.