经肛门引流管放置后获得的信息对结直肠癌前切除术后的意义。
Significance of information obtained during transanal drainage tube placement after anterior resection of colorectal cancer.
机构信息
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
出版信息
PLoS One. 2022 Aug 29;17(8):e0271496. doi: 10.1371/journal.pone.0271496. eCollection 2022.
INTRODUCTION
It has recently been reported that the placement of a transanal drainage tube after rectal cancer surgery reduces the rate of anastomotic leakage. However, transanal drainage tube cannot completely prevent anastomotic leakage and the management of transanal drainage tube needs to devise. We investigated the information obtained during transanal drainage tube placement and evaluated the relationship between these factors and anastomotic leakage.
PATIENTS AND METHODS
Fifty-one patients who underwent anterior resection of rectal cancer was retrospectively reviewed. transanal drainage tube was placed for more than 5 days after surgery. The daily fecal volume from transanal drainage tube was measured on postoperative day 1-5, and the defecation during transanal drainage tube placement was investigated.
RESULTS
Anastomotic leakage during transanal drainage tube placement occurred in 4 patients. The anastomotic leakage rate during transanal drainage tube placement in patients whose maximum daily fecal volume or total fecal volume from the transanal drainage tube during postoperative days 1-5 was large was significantly higher than that in patients whose fecal volume was small. The anastomotic leakage rate of the patients with intentional defecation during transanal drainage tube placement was significantly higher than that of the patients without intentional defecation during transanal drainage tube placement. The maximum daily fecal volume and the total fecal volume from the transanal drainage tube during postoperative days 1-5 in patients who experienced intentional defecation during transanal drainage tube placement was significantly higher than that of patients without intentional defecation during transanal drainage tube placement.
CONCLUSION
A large fecal volume from transanal drainage tube after anterior rectal resection or intentional defecation in patients with transanal drainage tube placement were suggested to be risk factors for anastomotic leakage.
介绍
最近有报道称，直肠癌手术后放置经肛门引流管可降低吻合口漏的发生率。然而，经肛门引流管并不能完全预防吻合口漏，需要对经肛门引流管的管理进行设计。我们调查了经肛门引流管放置过程中获得的信息，并评估了这些因素与吻合口漏之间的关系。
患者和方法
回顾性分析了 51 例接受直肠癌前切除术的患者。手术后，经肛门引流管留置时间超过 5 天。术后第 1-5 天，每天测量经肛门引流管的粪便量，并调查经肛门引流管放置期间的排便情况。
结果
4 例患者在经肛门引流管放置期间发生吻合口漏。经肛门引流管放置期间，最大日粪便量或术后第 1-5 天经肛门引流管总粪便量较大的患者，其吻合口漏发生率明显高于粪便量较小的患者。经肛门引流管放置期间有故意排便的患者的吻合口漏发生率明显高于无经肛门引流管放置期间故意排便的患者。经肛门引流管放置期间有故意排便的患者的最大日粪便量和术后第 1-5 天经肛门引流管总粪便量明显高于无经肛门引流管放置期间故意排便的患者。
结论
前直肠切除术后经肛门引流管的粪便量大或经肛门引流管放置期间有故意排便，提示是吻合口漏的危险因素。
Zotero 插件