Early Diagnosis and Prevention Measurements of Anastomotic Leakage after Low Anterior Resection for Rectal Cancer by Using Double-Stapled Anastomosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 冯斌 , 张飞妍

Corresponding author：

冯斌, Email: majjy3721@163.com

Keywords：

低位直肠癌前切除; 吻合口漏; 早期诊断; 防治

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目的　探讨应用双吻合器低位直肠癌前切除术后吻合口漏的早期诊断和防治措施。
方法　回顾性分析 2005～2011年期间笔者所在医院收治的160例应用双吻合器行低位直肠癌前切除患者的临床资料。
结果　本组患者术后发生吻合口漏13例（8.1%），发生吻合口漏的时间为术后 3～12d，平均7d；8例经保守治疗后治愈，4 例经二次手术行结肠或回盲部造瘘后好转，1 例于术后12d死亡。
结论　直肠癌前切除术后吻合口漏的早期正确诊断和合理治疗是降低患者死亡率的关键；早期的造瘘手术和通畅引流是治愈吻合口漏的必要措施。

Citation： 冯斌,张飞妍. Early Diagnosis and Prevention Measurements of Anastomotic Leakage after Low Anterior Resection for Rectal Cancer by Using Double-Stapled Anastomosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(12): 1338-1340. doi: Copy

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2.	Jung SH， Yu CS， Choi PW， et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery[J]. Dis Colon Ractum， 2008， 51(6)： 902-908．.
3.	Griffen FD， Knight CD Sr， Whitaker JM， et al. The double stapling technique for low anterior resection． Results， modifi-cations，and observations[J]. Ann Surg， 1990，211(6)：745-751.
4.	Bertelsen CA， Andreasen AH， Jørgensen T， et al. Anastomotic leakage after anterior resection for rectal cancer： risk factors[J]. Colorectal Dis，2010， 12(1)： 37-43.
5.	Weidenhagen R， Gruetzner KU， Wiecken T，et al. Endoseopic vacuum——assisted closure of anastomotic leakage followinganterior resection of the rectum：a new method[J]. SurgEndosc， 2008， 22(8)： 1818-1825．.
6.	Nesbakken A，Nygaard K，Lunde OC，et al. Anastomotic leak following mesorectal excision for rectal cancer：true incidence and diagnostic challenges[J]. Colorectal Dis， 2005， 7(6)：576-581.
7.	Law WI， Chu KW， Ho JW， et al. Risk factor for anastomotic leakage after low anterior resection with total mesorectal excision[J]. Am J Surg， 2000，179(2)： 92-96.
8.	Eriksen MT， Wibe A， Norstein J， et al. Anastomotic leakagefollowing routine mesorectal excision for rectal cancer in anational cohort of patients[J]. Colorectal Dis， 2005， 7(1)： 51-57.
9.	Kanellos I， Vasiliadis K， Angelopoulos S， et al. Anastomotic leakage following anterior resection for rectal cancer[J]. Tech Coloproctoi， 2004， 8(1)： 79-81.
10.	Doeksen A，Tanis PJ，Vrouenraets BC，et al. Factors determining delay in relaparotomy for anastomotic leakage after colorectalresection[J]. World J Gastroenterol， 2007， 13(27)：3721-3725.
11.	Almeida AB， Faria G， Moreira H， et al. Elevated serum C-reactiveprotein as a predictive factor for anastomotic leakage in colorectal surgery[J]. Int J Surg，2012，10(2)：87-91.
12.	Peeters KC， Tollenaar RA， Marijnen CA， et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer[J]. Br J Surg， 2005， 92(2) ： 211-216.
13.	Konishi T，Watanabe T，Kishimoto J，et al. Risk factors for anastomotic leakage after surgery for colorectal cancer： results of prospective surveillance[J]. J Am Coll Surg，2006，202(3)：439-444.
14.	Gastinger I， Marusch F， Steinert R， et al. Protective defunctioning stoma in low anterior resection for rectal carcinoma[J]. Br J Surg， 2005， 92(9) ：1137-1142.

1. Branagan G，Finnis D；Wessex Colorectal Cancer Audit Working Group. Prognosis after anastomotic leakage in colorectal surgery[J]. Dis Colon Rectum，2005，48(5)：1021-1026.
2. Jung SH， Yu CS， Choi PW， et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery[J]. Dis Colon Ractum， 2008， 51(6)： 902-908．.
3. Griffen FD， Knight CD Sr， Whitaker JM， et al. The double stapling technique for low anterior resection． Results， modifi-cations，and observations[J]. Ann Surg， 1990，211(6)：745-751.
4. Bertelsen CA， Andreasen AH， Jørgensen T， et al. Anastomotic leakage after anterior resection for rectal cancer： risk factors[J]. Colorectal Dis，2010， 12(1)： 37-43.
5. Weidenhagen R， Gruetzner KU， Wiecken T，et al. Endoseopic vacuum——assisted closure of anastomotic leakage followinganterior resection of the rectum：a new method[J]. SurgEndosc， 2008， 22(8)： 1818-1825．.
6. Nesbakken A，Nygaard K，Lunde OC，et al. Anastomotic leak following mesorectal excision for rectal cancer：true incidence and diagnostic challenges[J]. Colorectal Dis， 2005， 7(6)：576-581.
7. Law WI， Chu KW， Ho JW， et al. Risk factor for anastomotic leakage after low anterior resection with total mesorectal excision[J]. Am J Surg， 2000，179(2)： 92-96.
8. Eriksen MT， Wibe A， Norstein J， et al. Anastomotic leakagefollowing routine mesorectal excision for rectal cancer in anational cohort of patients[J]. Colorectal Dis， 2005， 7(1)： 51-57.
9. Kanellos I， Vasiliadis K， Angelopoulos S， et al. Anastomotic leakage following anterior resection for rectal cancer[J]. Tech Coloproctoi， 2004， 8(1)： 79-81.
10. Doeksen A，Tanis PJ，Vrouenraets BC，et al. Factors determining delay in relaparotomy for anastomotic leakage after colorectalresection[J]. World J Gastroenterol， 2007， 13(27)：3721-3725.
11. Almeida AB， Faria G， Moreira H， et al. Elevated serum C-reactiveprotein as a predictive factor for anastomotic leakage in colorectal surgery[J]. Int J Surg，2012，10(2)：87-91.
12. Peeters KC， Tollenaar RA， Marijnen CA， et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer[J]. Br J Surg， 2005， 92(2) ： 211-216.
13. Konishi T，Watanabe T，Kishimoto J，et al. Risk factors for anastomotic leakage after surgery for colorectal cancer： results of prospective surveillance[J]. J Am Coll Surg，2006，202(3)：439-444.
14. Gastinger I， Marusch F， Steinert R， et al. Protective defunctioning stoma in low anterior resection for rectal carcinoma[J]. Br J Surg， 2005， 92(9) ：1137-1142.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Early Diagnosis and Prevention Measurements of Anastomotic Leakage after Low Anterior Resection for Rectal Cancer by Using Double-Stapled Anastomosis

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