結(jié)直腸癌切除術后并發(fā)吻合口瘺的危險因素分析及防治措施.pdf

1、新疆醫(yī)科大學碩士學位論文結(jié)直腸癌切除術后并發(fā)吻合口瘺的危險因素分析及防治措施姓名：買爾旦·賽力木申請學位級別：碩士專業(yè)：外科學（胃腸外科）指導教師：王云海2010-04新疆醫(yī)科大學醫(yī)學碩士學位論文 新疆醫(yī)科大學醫(yī)學碩士學位論文 —２—Risk factors and the management of anastomotic leakage after carcinectomy for colorectal cancer P

2、ostgraduate: MaiErDan Supervisor: Prof. Wang Yunhai Abstract Objective: To investigate the risk factors and management of anastomotic leakage after carcinectomy for colorectal cancer.Methods: The clinical data of 122

3、colorectal cancer patients,undergone carcinectomy from 2007 to 2009,were analyzed retrospectively. Results: The incidence of anastomotic leakage were among the 122 colorectal cancer patients was 10.7%(13 patients). The c

4、omplication of anastomotic leakage was associated with age(15.8% in older than 60 years versus2.2% in younger than 60 years), physical status (18.8% in poor condition patients versus7.8% in good condition patients),bowel

5、 obstruction (28.6% with obstruction versus 8.3% without obstruction),anastomotic location(17.8% for outside of peritoneal anastomosis versus 6.5% for inside of peritoneal anastomosis),anastomotic style(15.2% for handiwo

6、rk anastomosis versus 7.9% for anastomat).The rates of anastomotic leakage in staple-line manual reinforce group and with stoma group was significantly decreased than those in control groups(1.9% versus 21.7% and 6.3% ve

7、rsus 13.5%)(P<0.05). Eleven cases of anastomotic leakage were treated by conservative therapy. The treatment included nutritional support, catheter drainage of abdominal abscesses and the use of antibiotics. One patie

8、nt was dead. The other 2 patients were healed by loop colostomy of transverse colon respectively. Conclusions: Elderly patients, poor general condition, preoperative tumor obstruction, outside of peritoneal anastomosis,

9、handiwork anastomosis, none staple-line manual reinforce, none stoma are independent risk factors for the development of anastomotic leakage. The treatment of anastomotic leakage include conservative therapy and operativ