CAJ | 학술논문

目的：探讨直肠癌低位／超低位前切除术中预防吻合口瘘的操作技巧。方法：对我院2008年1月至2014年12月期间直肠癌行低位／超低位前切除术后出现吻合口瘘患者的临床资料和术中操作技巧进行分析总结。结果：35例患者术后出现吻合口瘘，吻合口瘘发生率4．26％（35／822）；吻合口瘘发生时间为术后4天～25天（中位8天）。13例（37．1％）患者行肠造瘘手术，22例（62．9％）行局部置管冲洗引流，配合全身营养支持治愈，无死亡病例。结论：注重术中操作技巧，确保肠段的血供和无张力，施行高质量的吻合是预防直肠癌低位／超低位前切除术后吻合口瘘的关键。
목적：탐토직장암저위／초저위전절제술중예방문합구루적조작기교。방법：대아원2008년1월지2014년12월기간직장암행저위／초저위전절제술후출현문합구루환자적림상자료화술중조작기교진행분석총결。결과：35례환자술후출현문합구루，문합구루발생솔4．26％（35／822）；문합구루발생시간위술후4천～25천（중위8천）。13례（37．1％）환자행장조루수술，22례（62．9％）행국부치관충세인류，배합전신영양지지치유，무사망병례。결론：주중술중조작기교，학보장단적혈공화무장력，시행고질량적문합시예방직장암저위／초저위전절제술후문합구루적관건。
Objective:To investigate the major surgical skills to prevent anastomotic leakage following low/super-low anterior resection of rectal cancer.Methods:Clinical data and intra-operative surgical manoeuvre of patients with anas-tomotic leakage after low/super-low rectal resection from January 2008 to December 2014 were retrospectively reviewed and summarized.Results:There were 35 cases (35/822,4.26%)with anastomotic leakage developed within 4 ~25 days (Median 8 days)after surgery.Thirteen cases (37.1%)were cured by temporary enterostomy,while the other 22 cases (62.9%)received conservative treatments with regional irrigation and drainage,together with nutritional supports.None death occurred in this group.Conclusions:Improvement of surgical skills to make satisfying anastomosis with sufficient blood supply and tensionless construction is the key point for prevention of postoperative leakage in operation.