末段回肠置管造口预防直肠前切除术 后吻合口漏（附64例临床报道）

Ileostomy via indwelling catheter in terminal ileum to prevent anastomotic leakage after anterior resection of the rectum (64 cases reports)

摘要:

目的 探讨末段回肠置管造口预防直肠前切除术后吻合口漏的临床应用价值。方法 对64例腹腔镜及开放直肠前切除保肛手术患者，手术进行至结直肠吻合完毕后，经末段回肠置入一球囊气管导管造口，并妥善固定，观察术后肠内容物转流效果及吻合口漏的发生情况。结果 全组患者肠内容物转流彻底，无肠梗阻发生，吻合口漏1例，经保守治疗短期内愈合。拔管后无肠漏及腹膜炎发生，术后可早期进食，恢复满意。结论 末段回肠置管造口简单实用，能有效防治直肠前切除术后吻合口漏的发生，并可免除二次手术回纳肠管。

Abstract:

【Objective】 To evaluate the clinical value of ileostomy via indwelling catheter in terminal ileum to prevent anastomotic leakage after anterior resection of the rectum. 【Methods】 64 cases of patients underwent laparoscopic/open anterior resection of the rectum, a balloon endotracheal tube was placed in the terminal ileum for ileostomy after completion of the terminal colorectal anastomosis and fixed properly. Then the intestinal transit function and the occurrence rate of anastomotic leakage were observed after operation. 【Results】 All groups of patients'intestinal transit function was well and no intestinal obstruction was observed. One case of anastomotic leakage occurred with recovery shortly after conservative treatment. No fecal leakage or peritonitis occurred after extubation. The patients could start taking food early after operation and their recovery was satisfying. 【Conclusion】 Ileostomy via indwelling catheter in terminal ileum was simple and practical. It is an effective prevention and treatment for the occurrence of anastomotic leakage after anterior resection of the rectum which could exempt patients from resurgery for repositioning the bowels.