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目的:探讨直肠癌保肛术后吻合口瘘发生的原因、诊断、处理及预防措施。方法:对2002年1月至2009年8月施行直肠癌保肛手术后吻合口瘘11例的临床资料进行回顾性分析。结果:直肠保肛术后吻合口瘘发生率为9.8%,其中10例经非手术治疗痊愈,1例再次手术治疗痊愈。结论:充分的术前准备,重视吻合口的血运、张力,正确使用吻合器,合理选放引流管是防止瘘发生的关键。及时有效的引流,绝大多数可获痊愈。
Objective: To investigate the causes, diagnosis, treatment and preventive measures of anastomotic leakage after rectocelectomy for rectal cancer. Methods: The clinical data of 11 cases of anastomotic leakage after rectal cancer surgery from January 2002 to August 2009 were retrospectively analyzed. RESULTS: The incidence of anastomotic fistula after rectal anus preservation was 9.8%, of which 10 cases were healed by non-surgical treatment and 1 case was healed again by surgery. Conclusion: Adequate preoperative preparation, importance of blood supply and tension in anastomotic stoma, proper use of stapler, and reasonable placement of drainage tube are the key to prevent sputum formation. Timely and effective drainage, the vast majority can be cured.