Moran B J, Heald R J
Colorectal Research Unit, North Hampshire Hospital, Basingstoke, UK.
Colorectal Dis. 2001 Mar;3(2):135-7. doi: 10.1046/j.1463-1318.2001.00210.x.
Anastomotic leakage is one of the most serious early complications of any rectal anastomosis. Proximal defunctioning mitigates the consequences of leakage but does not abolish the risk. The lower the anastomosis the higher the risks of leakage. There is evidence that a short colon pouch reduces the risks of leakage. A high index of suspicion is required to detect the early non-specific signs of anastomotic leakage. Urgent surgical intervention is usually required to avert a life threatening situation. Reports of the demise of temporary defunctioning of the low anastomosis are premature, and judicious use of faecal diversion should never be regarded as surgical temerity.
吻合口漏是任何直肠吻合术最严重的早期并发症之一。近端去功能化可减轻漏出的后果，但并不能消除风险。吻合口位置越低，漏出风险越高。有证据表明，短结肠袋可降低漏出风险。需要高度怀疑才能检测到吻合口漏的早期非特异性体征。通常需要紧急手术干预以避免危及生命的情况。关于低位吻合口临时去功能化失败的报道为时过早，明智地使用粪便转流绝不应被视为手术轻率行为。
