Ishibe A, Ota M, Kanazawa A, Watanabe J, Tatsumi K, Watanabe K, Godai T, Yamagishi S, Fujii S, Ichikawa Y, Kunisaki C, Endo I
Hepatogastroenterology. 2015 Jan-Feb;62(137):30-3.
BACKGROUND/AIMS: Anastomotic leakage is major complication of colorectal surgery. Total parenteral nutrition (TPN) and fasting are conservative treatments for leakage in the absence of peritonitis in Japan. Elemental diet (ED) jelly is a completely digested formula and is easily absorbed without secretion of digestive juices. The purpose of this study was to assess the safety of ED jelly in management of anastomotic leakage.
Six hundred and two patients who underwent elective surgery for left side colorectal cancer from January 2008 to December 2011 were included in the study. Pelvic drainage was performed for all patients. Sixty-three (10.5%) patients were diagnosed with an anastomotic leakage, and of these, 31 (5.2%) without diverting stoma were enrolled in this study.
Sixteen patients received TPN (TPN group) and 15 patients received ED jelly (ED group). The duration of intravenous infusion was significantly shorter in the ED group than in the TPN group (15 days versus 25 days, P= 0.008). In the TPN group, catheter infection was occurred in 2 patients who required re-insertion of the catheter.
Conservative management of anastomotic leakage after colorectal surgery with ED jelly appears to be a safe and useful approach.
背景/目的：吻合口漏是结直肠手术的主要并发症。在日本，对于无腹膜炎的吻合口漏，全胃肠外营养（TPN）和禁食是保守治疗方法。要素饮食（ED）果冻是一种完全消化的配方，无需消化液分泌即可轻松吸收。本研究的目的是评估ED果冻在处理吻合口漏方面的安全性。
纳入2008年1月至2011年12月期间接受择期左侧结直肠癌手术的602例患者。所有患者均行盆腔引流。63例（10.5%）患者被诊断为吻合口漏，其中31例（5.2%）未行转流造口的患者纳入本研究。
16例患者接受TPN（TPN组），15例患者接受ED果冻（ED组）。ED组静脉输注时间明显短于TPN组（15天对25天，P = 0.008）。在TPN组，2例患者发生导管感染，需要重新插入导管。
结直肠手术后用ED果冻对吻合口漏进行保守治疗似乎是一种安全有效的方法。
