RISK OF PERITONITIS AND FATAL SEPTICEMIA AND THE NEED TO DEFUNCTION THE LOW ANASTOMOSIS

被引:188
作者
KARANJIA, ND [1 ]
CORDER, AP [1 ]
HOLDSWORTH, PJ [1 ]
HEALD, RJ [1 ]
机构
[1] BASINGSTOKE DIST GEN HOSP,COLORECTAL RES UNIT,BASINGSTOKE RG24 9NA,HANTS,ENGLAND
关键词
D O I
10.1002/bjs.1800780221
中图分类号
R61 [外科手术学];
学科分类号
摘要
The aim of this study was to investigate the need to defunction the low anastomosis after anterior resection of the rectum with total mesorectal excision for rectal cancer. Two hundred consecutive patients (125 defunctioned, 75 non-defunctioned) undergoing low anterior resection for carcinoma were included in the study. Peritonitis requiring emergency laparotomy occurred in 8 per cent of the patients who did not have a defunctioning stoma compared with less than 1 per cent of those patients who had a defunctioning stoma (P < 0.01). There was no mortality related to closure of the stoma but seven patients developed a faecal fistula and ten developed an incisional hernia. Despite current trends to avoid the defunctioning stoma, these results suggest that after total mesorectal excision the faecal stream should be temporarily diverted away from the anastomosis that is 6 cm or less from the anal verge to protect against potentially life-threatening anastomotic leakage.
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页码:196 / 198
页数:3
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