Heald R J, Leicester R J
Br J Surg. 1981 May;68(5):333-7. doi: 10.1002/bjs.1800680514.
The complications of 100 stapled anastomoses onto the rectum or anus are reviewed. Anastomotic leakage in very low cases is the major problem; no leak occurred if the anastomosis was performed above 7 cm, but 3 leaks in 17 patients occurred if the anastomosis was performed between 5.5 and 7 cm, and 10 leaks occurred in 52 patients if the anastomoses was less than 5 cm from the anal margin. A covering colostomy is essential for these lower anastomoses, and for those not covered by a colostomy, an immediate colostomy with a distal loop washout is performed, if a leak develops. Attention to technique is mandatory, with a good blood supply, absence of tension and the elimination of the pelvic cavity being of great importance.
回顾了100例直肠或肛门吻合器吻合术的并发症。极低位置吻合口漏是主要问题；吻合口在7cm以上时未发生漏，但在5.5至7cm之间吻合时，17例患者中有3例发生漏，而吻合口距肛缘小于5cm时，52例患者中有10例发生漏。对于这些低位吻合术，覆盖性结肠造口术至关重要，对于未行结肠造口术的患者，如果发生漏，则立即行结肠造口术并进行远端肠袢冲洗。必须注意技术，良好的血供、无张力以及消除盆腔非常重要。
