Objective To investigate the measures to prevent the anastomotic leakage following anterior resection of rectum.
Methods A series of seventy-four patients with rectal cancer undergoing anterior resection from January 1991 to October 1998 were analyzed.
Results The clinical anastomotic leakage rate was 4.05 per cent (3/74). The causes of leakage were presacral infection and insufficiency of blood supply in incisional margin.
Conclusion The proximal colon must be completely mobilized and blood supply of incisional margin should be sufficient. Persistent postoperative presacral suction must be performed to protect fluid accumulation resulting in infection. Intracolonic drainage is an important factor in prevention of anastomotic leakage. Temporary stoma is not necessary.
Citation：
ZHANG Mingde,GAO Youfu,WANG Hongqiang,et al.. CAUSES AND PROPHYLAXIS OF ANASTOMOTIC LEAKAGE FOLLOWING ANTERIOR RESECTION OF RECTUM CARCINOMA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2000, 7(5): 315-317. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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Goligher JC, Grahan NG, Dombal FT. Anastomotic dehiscence after anterior resection of rectum and sigmoid 〔Ｊ〕. Br J Surg, 1970; 57(1)∶109.
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Schrock TR, Deveney CW, Dunphy JE. Factors contributing to leakage of colonic anastomoses 〔Ｊ〕. Ann Surg, 1973; 177(5)∶513.
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| 3. |
Karanjia ND, Corder AP, Holdsworth PJ, et al. Risk of peritonitis and fatal septicaemia and need to defunction the low anastomosis 〔Ｊ〕. Br J Surg, 1991; 78(2)∶196.
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Dixion A, Maxwell W, Thorton HJ. Carcinoma of the rectum: a 10year experience 〔Ｊ〕. Br J Surg, 1991; 78(3)∶308.
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| 5. |
Grabham JA, Moran BJ, Lane RHS. Defunctioning colostomy for low anterior resection: a selective approach 〔Ｊ〕. Br J Surg, 1995; 82(10)∶1331.
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| 6. |
Dehni N, Schlegel RD, Cunningham C, et al. Influence of a defunctioning stoma on leakage rates after low colorectal anastomosis and colonic J pouchanal anastomosis 〔Ｊ〕. Br J Surg, 1998; 85(8)∶1114.
|
| 7. |
Rullier E, Laurent C, Garrelon JL, et al. Risk factors for anastomotic leakage after resection of rectal cancer 〔Ｊ〕. Br J Surg, 1998; 85(3)∶355.
|
| 8. |
郁宝铭， 李东华， 郑民华等. 双吻合器在低位直肠癌手术中的地位： 附113例分析 〔Ｊ〕. 实用外科杂志， 1996； 16(3)∶140.
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傅传刚， 金国祥， 屠岳等. 双吻合器吻合法在直肠癌保肛手术中的应用 〔Ｊ〕. 中华普通外科杂志， 1999； 14(1)∶48.
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| 10. |
Beahrs OH. Complications of colonic surgery 〔Ｊ〕. Surg Clin N Am, 1967; 47(8)∶983.
|
| 11. |
Fazio VW. Sump suction and irrigation of the presacral space 〔Ｊ〕. Dis Colon Rectum, 1978; 21(6)∶401.
|
| 12. |
Hawley PR, Faulk WP, Hunt TK, et al. Collagenase activity in the gastrointestinal tract 〔Ｊ〕. Br J Surg, 1970; 57(12)∶896.
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- 1. Goligher JC, Grahan NG, Dombal FT. Anastomotic dehiscence after anterior resection of rectum and sigmoid 〔Ｊ〕. Br J Surg, 1970; 57(1)∶109.
- 2. Schrock TR, Deveney CW, Dunphy JE. Factors contributing to leakage of colonic anastomoses 〔Ｊ〕. Ann Surg, 1973; 177(5)∶513.
- 3. Karanjia ND, Corder AP, Holdsworth PJ, et al. Risk of peritonitis and fatal septicaemia and need to defunction the low anastomosis 〔Ｊ〕. Br J Surg, 1991; 78(2)∶196.
- 4. Dixion A, Maxwell W, Thorton HJ. Carcinoma of the rectum: a 10year experience 〔Ｊ〕. Br J Surg, 1991; 78(3)∶308.
- 5. Grabham JA, Moran BJ, Lane RHS. Defunctioning colostomy for low anterior resection: a selective approach 〔Ｊ〕. Br J Surg, 1995; 82(10)∶1331.
- 6. Dehni N, Schlegel RD, Cunningham C, et al. Influence of a defunctioning stoma on leakage rates after low colorectal anastomosis and colonic J pouchanal anastomosis 〔Ｊ〕. Br J Surg, 1998; 85(8)∶1114.
- 7. Rullier E, Laurent C, Garrelon JL, et al. Risk factors for anastomotic leakage after resection of rectal cancer 〔Ｊ〕. Br J Surg, 1998; 85(3)∶355.
- 8. 郁宝铭， 李东华， 郑民华等. 双吻合器在低位直肠癌手术中的地位： 附113例分析 〔Ｊ〕. 实用外科杂志， 1996； 16(3)∶140.
- 9. 傅传刚， 金国祥， 屠岳等. 双吻合器吻合法在直肠癌保肛手术中的应用 〔Ｊ〕. 中华普通外科杂志， 1999； 14(1)∶48.
- 10. Beahrs OH. Complications of colonic surgery 〔Ｊ〕. Surg Clin N Am, 1967; 47(8)∶983.
- 11. Fazio VW. Sump suction and irrigation of the presacral space 〔Ｊ〕. Dis Colon Rectum, 1978; 21(6)∶401.
- 12. Hawley PR, Faulk WP, Hunt TK, et al. Collagenase activity in the gastrointestinal tract 〔Ｊ〕. Br J Surg, 1970; 57(12)∶896.
