论文部分内容阅读
目的吻合口瘘目前仍是直肠癌前切除术后的最严重并发症之一。本研究旨在探讨预防性应用止泻药物对防止腹腔镜直肠癌术后吻合口瘘的作用。方法回顾性分析587例腹腔镜辅助直肠癌Dixon术后吻合口瘘的发生和治疗情况,对预防性应用止泻药物组(A组)、未应用止泻药物且未预防性回肠造瘘组(B组)、预防性回肠造瘘组(C组)患者的临床资料进行对比观察。结果 A组患者术后吻合口瘘发生率为2.29%(5/218),均经保守治疗治愈,平均治愈时间为(9.95±1.82)d;B组患者术后吻合口瘘发生率为8.72%(15/172),其中有2例经保守治疗治愈,其余患者予横结肠造瘘、局部冲洗引流治疗后愈合,平均治愈时间为(18.58±2.15)d;C组患者术后吻合口瘘发生率为2.54%(5/197),均经保守治疗治愈,平均治愈时间为(10.32±1.91)d。A组及C组的吻合口瘘发生率明显低于B组(χ~2=13.028,P<0.001;χ~2=12.852,P<0.001),A组与C组吻合口瘘发生率的比较差异无统计学意义,χ~2=1.183,P=0.816。A组(t=4.127,P=0.001)及C组(t=3.963,P=0.001)的吻合口瘘平均愈合时间明显少于B组,A组与C组吻合口瘘平均愈合时间的比较差异无统计学意义,t=0.287,P=0.725。结论预防性应用止泻药物能够有效防止腹腔镜辅助直肠癌Dixon术后吻合口瘘的发生。
Anastomotic fistula is still one of the most serious complications after anterior resection of rectum. The purpose of this study was to explore the role of prophylactic antidiarrheal drugs in preventing postoperative anastomotic leakage of laparoscopic rectal cancer. Methods A retrospective analysis of 587 cases of laparoscopic assisted rectal cancer after Dixon anastomotic fistula occurred and treatment of prophylactic use of antidiarrheal drug group (A group), did not use antidiarrheal drugs and unprotected ileostomy group ( B group), preventive ileostomy group (C group) clinical data were compared. Results The incidence of postoperative anastomotic fistula in group A was 2.29% (5/218), all of which were cured by conservative treatment. The average healing time was (9.95 ± 1.82) d. The incidence of anastomotic fistula in group B was 8.72% (15/172), of which 2 cases were cured by conservative treatment. The other patients were treated with transverse colostomy, followed by local irrigation and drainage. The average healing time was (18.58 ± 2.15) days. The incidence of anastomotic fistula in group C 2.54% (5/197), were cured by conservative treatment, the average healing time was (10.32 ± 1.91) d. The incidence of anastomotic fistula in group A and group C was significantly lower than that in group B (χ ~ 2 = 13.028, P <0.001; χ ~ 2 = 12.852, P <0.001) The difference was not statistically significant, χ ~ 2 = 1.183, P = 0.816. The average healing time of anastomotic fistulas in group A (t = 4.127, P = 0.001) and group C (t = 3.963, P = 0.001) was significantly less than that in group B. The average healing time of anastomotic fistula in group A and group C was significantly different Not statistically significant, t = 0.287, P = 0.725. Conclusion Preventive use of antidiarrheal drugs can effectively prevent the occurrence of anastomotic fistula after laparoscopic assisted rectal cancer Dixon operation.