Department of Surgery, Charité- Universitätsmedizin Berlin, Berlin, Germany.
Colorectal Dis. 2011 Mar;13(3):284-9. doi: 10.1111/j.1463-1318.2009.02140.x.
Colonic J-pouch reconstruction is widely carried out during low anterior resection. The aim of this observational study was to describe the complications and evaluate the results of adverse event management.
A total of 128 patients underwent an elective anterior resection with colorectal or coloanal J-pouch reconstruction for primary rectal cancer between January 1997 and December 2008.
The overall mortality was 1.6%. Three (2.3%) patients developed pouch necrosis, one of whom died. The rate of anastomotic leakage was 11.7%. Other major complications included intra-abdominal abscess (3.1%), haemorrhage (0.8%) and abdominal dihiscence (0.8%). In all cases of anastomotic leakage, the pouch was salvaged, with 80% of patients undergoing surgical revision with relaparotomy and transanal suture. Patients with pouch necrosis underwent relaparotomy with removal of the pouch and a terminal colostomy. In all cases of intra-abdominal abscess without anastomotic leakage, radiologically controlled percutaneous drainage was carried out.
Anal function can usually be saved after anastomotic leakage by salvage surgery without increase in mortality.
直肠前切除术中广泛行结肠 J 袋重建。本观察性研究旨在描述并发症，并评估不良事件处理的结果。
1997 年 1 月至 2008 年 12 月期间，共有 128 例行择期直肠前切除术的患者接受直肠或结直肠 J 袋重建术治疗原发性直肠癌。
总死亡率为 1.6%。3 例（2.3%）患者发生袋坏死，其中 1 例死亡。吻合口漏的发生率为 11.7%。其他主要并发症包括腹腔脓肿（3.1%）、出血（0.8%）和腹部裂开（0.8%）。所有吻合口漏的患者均进行了袋挽救，80%的患者接受了再次剖腹手术和经肛门缝合修复。发生袋坏死的患者行再次剖腹手术切除袋并进行末端结肠造口术。所有无吻合口漏的腹腔脓肿患者均进行了经放射控制的经皮引流。
吻合口漏后通过挽救手术通常可以保留肛门功能，而不会增加死亡率。
