【作者】 刘平；

【导师】 张海山；

【作者基本信息】 吉林大学 ， 临床医学， 2007， 硕士

【摘要】 直肠癌(rectal cancer)是我国常见的恶性肿瘤,占消化道恶性肿瘤第二位,我国直肠癌中低位直肠癌所占比例高,约占75%,多数直肠癌在直肠指诊时可见触及,青年人(<30岁)比例较高,约占15%。直肠癌根治性切除术后5年生存率约为50%~70%。Dukes A期病人癌根治性切除术后5年生存率可达90%以上。直肠癌的外科治疗最早开始于十八世纪初。经历了3个世纪,直肠癌手术有了很大的发展。本文就直肠癌的治疗进展进行综述。吻合口漏是直肠癌手术后常见的并发症。本文回顾性分析了自2002年1月～2006年12月在吉林大学附属第三医院(中日联谊医院)普通外科对317例直肠癌行保肛手术,对术后资料进行回顾性统计分析,探讨直肠癌保肛手术术后吻合口漏的发生率和相关危险因素,及吻合口漏的预防、诊断和治疗,总结经验,以提高直肠癌的治疗水平。更多还原

【Abstract】 Objective: To investigate the anastomotic leakage rate risk factors and treatment methods after anus-preserving for rectal carcinoma.Methods: Three hundred and fourteen patients with rectal cancers (3~14 cm from anal verge) underwent anus-preserving for rectal carcinoma with stapling technique, data were analyzed and compared retrospectively.Results: Anastomotic leakage rate was 7.6%, in which 95.8% (23/24)of patents were treated successfully with tube irrigation alone, 4.2% (1/24) received transverse colostomy after failure of conservative treatment. Age, distance of tumor from anal verge, low albumen, rectal carcinoma with intestinal obstruction, and diabetes were related to the leakage (P<0.05 or 0.01), while sex was not related to leakage.Conclusion: Anastomotic leakage is one of the commonest intraoperative complications after anus-preserving operation for rectal carcinoma; low rectal cancers will have more anastomotic leakage rate; The majority of anastomotic leakage can be treated successfully by tran drainage tube irrigation alone, laparotomy and proximal colostomy is necessary for a few cases. We suggest giving patients enteral nutrition after anastomotic leakage as early as possible.更多还原