【摘要】 目的探讨直肠癌前切除手术术后吻合口漏的相关危险因素。方法对1999年6月～2009年6月我院行直肠癌前切除手术患者628例的临床资料行回顾性研究,分析影响术后吻合口漏发生的危险因素。结果 628例直肠癌前切除术后共发生吻合口漏54例(8.6%,54/628)。患者术前有糖尿病病史、术前血清白蛋白<35g/L、术中没有行预防性近端肠造口、肿瘤下端距肛缘距离≤7cm、肿瘤病灶直径>5cm是患者术后发生吻合口漏的危险因素。并且肿瘤下端距肛缘距离≤7cm是术后发生吻合口漏的独立危险因素(P<0.05)。结论低位直肠癌、肿瘤较大、合并糖尿病及营养不良是直肠癌术后吻合口漏的危险因素,行保护性近端肠造瘘可以预防吻合口漏的发生。更多还原

【Abstract】 Objective To identify the risk factors associated with anastomotic leakage following an anterior resection for rectal cancer. Methods Between June,1999 and June,2009,628 patients underwent anterior resection for rectal cancer. A retrospective study of the cases was performed to identify the risk factors for anastomotic leakage following the resection. Results The overall incidence rate of anastomic leak was 8.6%(54/628) in these patients. A low albumin level(less than 35 g/L) ,diabetes,absence of a protective stoma,a distance less than 7 cm from the tumor to the anal edge,and a tumor diameter over 5 cm were identified as the risk factors for anastomotic leakage after anterior resection. Conclusion For patients at a high risk for anastomotic leakage,a protective stoma can significantly decrease the rate of clinical leaks and subsequent reoperation after low anterior resection for rectal cancer.更多还原