直肠癌患者行直肠前切除术形成硬吻合的结果

E. Kolesnikov, A. V. Snezhko, V. Trifanov, M. A. Kozhushko, Y. Fomenko, T. B. Katsieva, R. E. Myagkov, S. V. Sanamyanc, M. Averkin, G. Y. Egorov
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引用次数: 2

摘要

研究目的:回顾性分析直肠癌前直肠切除术的直接效果。材料和方法。在俄罗斯卫生部国家肿瘤医学研究中心第一腹部肿瘤科采用一组x线血管诊疗方法的诊所,对334例直肠癌患者进行了直肠前切除手术治疗,其中143例(42.8%)患者的诊断率较低。作为标准,进行全肠系膜切除和D2体积淋巴清扫。68例(20.4%)局部扩散肿瘤患者行联合手术治疗。通常,它们是本质上的切除,并且肿瘤浸润邻近器官(膀胱伴输尿管、卵巢、子宫、阴道、小肠、腹壁)。所有病例均采用交联装置形成结直肠吻合,其中316例(94.6%)为“侧对端”吻合,18例为“端对端”吻合。预防性肠近端造口73例(21.9%),其中回肠造口67例,横断造口6例。261例患者未形成预防性肠近端造口。结果。75例(22.5%)患者在直肠癌手术前切除术后出现并发症。最具威胁和危险的并发症是结直肠吻合术失败,12例(3.5%)发生。预防性造口治疗患者中有8.2%(73例中有6例)发生这种并发症,未造口患者中有2.3%(261例中有6例)发生这种并发症。使用预防性近端肠造口,即使在存在复杂形式的直肠癌的情况下,也可以形成结直肠吻合。直接涉及预防性肠近端造口形成的并发症数量相对较少,但在对无并发症的直肠癌进行手术规划时,应考虑其可能发生的概率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The results of anterior rectal resection with the formation of a hardware anastomosis in cancer patients
Purpose of the study. A retrospective analysis of the immediate results of performing anterior rectal resections in cancer. Materials and methods. In the Department of Abdominal Oncology No. 1 with a group of X-ray vascular methods of diagnosis and treatment of the clinic of the National Medical Research Centre for Oncology of the Ministry of Health of Russia treatment for rectal cancer operations of anterior rectal resection were performed in 334 patients, while in 143 (42.8 %) cases they were low. As a standard, total mesenteric excision and lymphoid dissection in volume D2 were performed. Combined surgical interventions were performed in 68 (20.4 %) patients for locally spread tumors. As a rule, they were resection in nature and were performed with tumor infiltration of adjacent organs (bladder with ureters, ovaries, uterus, vagina, small intestine, abdominal wall). Colorectal anastomosis using crosslinking devices was formed in all cases, in 316 (94.6 %) cases it was a "side – to-end" junction, in 18 patients – "end-to-end". A preventive proximal intestinal stoma was formed in 73 (21.9 %) cases, where 67 cases it was an ileostomy, and 6 – a transversostomy. The preventive proximal intestinal stoma was not formed among 261 patients. Results. After performing anterior resections for rectal cancer operations, the complications developed in 75 (22.5 %) patients. The most threatening and dangerous complication was the failure of the colorectal anastomosis, which was noted in 12 (3.5 %) cases.This complication occurred in 8.2 % (6 patients out of 73) of preventatively stoma-treated patients, in 2.3 % of patients without a stoma (6 patients out of 261).Conclusion. The use of a preventive proximal intestinal stoma allows you to form a colorectal anastomosis even in the presence of complicated forms of rectal cancer. The number of complications directly referred to the formation of a preventive proximal intestinal stoma is relatively small, but when planning surgery for uncomplicated rectal cancer, the probability of their possible occurrence should be taken into account.
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