Dimitriou Nikoletta, Panteleimonitis Sofoklis, Dhillon Ajit, Boyle Kirsten, Norwood Mike, Hemingway David, Yeung Justin, Miller Andrew
Colorectal Department, Leicester Royal Infirmary, Leicester, UK.
, 26, Mikras Asias str, Athens, 11527, Greece.
World J Surg Oncol. 2015 Dec 4;13:331. doi: 10.1186/s12957-015-0742-z.
The aims of the study were to determine the radiological leak rate in those patients who had undergone a resection for left-sided colorectal cancer and to see if the presence of a leak can be related with the postoperative clinical period. We also aimed to identify any common factors between patients with leak.
A retrospective analysis of prospectively collected data of all patients who underwent a left-sided colorectal cancer resection with formation of a defunctioning ileostomy was undertaken. Between 2005 and 2010, 418 such patients were identified.
A water-soluble contrast enema was performed in 339 patients (81.1 %). Of these, 24 (7.1 %) were reported to show an anastomotic leak. Data for these 24 patients is presented in this study. Twenty-three (95.8 %) of the leaks occurred in patients who had undergone an anterior resection; 95.8 % of the patients with a leak were male. Fifteen (62.5 %) patients underwent neo-adjuvant radiation. The mean length of stay in those patients shown to have a subsequent radiological leak was 18.8 days (median), compared with the overall unit figures of 12 days. Only 29.2 % of the patients who had a leak identified had an uncomplicated postoperative period. Overall 87.5 % of the patients had a reversal of the ileostomy.
Radiological leakage is not uncommon. The majority of patients, who were shown to have a radiological leak in this study, were male, had undergone an anterior resection, had received neo-adjuvant radiation, had a longer initial length of stay and had postoperative complications. Water-soluble contrast enemas could be selectively used in patients with these characteristics.
本研究的目的是确定接受左侧结直肠癌切除术患者的放射学渗漏率，并观察渗漏的存在是否与术后临床病程相关。我们还旨在确定发生渗漏的患者之间的任何共同因素。
对所有接受左侧结直肠癌切除术并形成失功回肠造口术的患者的前瞻性收集数据进行回顾性分析。在2005年至2010年期间，共识别出418例此类患者。
339例患者（81.1%）接受了水溶性造影剂灌肠。其中，24例（7.1%）报告显示存在吻合口渗漏。本研究展示了这24例患者的数据。23例（95.8%）渗漏发生在接受前切除术的患者中；95.8%的渗漏患者为男性。15例（62.5%）患者接受了新辅助放疗。显示有放射学渗漏的患者的平均住院时间为18.8天（中位数），而整个科室的平均住院时间为12天。仅有29.2%的被发现有渗漏的患者术后病程无并发症。总体而言，87.5%的患者回纳了回肠造口。
放射学渗漏并不罕见。本研究中显示有放射学渗漏的大多数患者为男性，接受了前切除术，接受了新辅助放疗，初始住院时间较长且有术后并发症。对于具有这些特征的患者，可选择性地使用水溶性造影剂灌肠。
