器械吻合を用いた直腸癌低位前方切除術の術後合併症とその対策

The complications and their treatment after low anterior resection for rectum carcinoma with auto sture

Creators Tanaka Akiyoshi

Creators Misuta Eishi

Creators Uchiyama Tetsuji

Creators Nishihara Kenji

Creators Adachi Jun

Creators Shimizu Ryoichi

Creators Oka Masaaki

Creators Murakami Takuo

Creators Suzuki Takashi

From May, 1982, low anterior resection with EEA(end to end anastomisis) equipment had been undergone for 30 patients with rectum carsinoma. As postoperetive complications, anastomotic lealage was obsered in 13.3% of cases, bleeding at anastmotic site lasting for more than 2days in 10.0%, and anastmotic narrowing smaller than the size of index finger in 6.7%. Anastomotic leakage had healed up with conservative therapy including fasting, IVH and appororiate drainage. The preoperative nutritious state in the anastomotic leakage group was compered with that in the no leakage group by means of total serum protein, albumin, cholestrol, and cholinesterase as indicators, and no significant difference was recognized. Therefore, the cause od anastomotic leakage was presumed to be the failure in manipulation of EEA or the inconsideration of anatomical factor of lower rectum. Bleeding from the anastomotic site was major somplication in patient with leakage and was stopped by conserbative therapy alone. The anastomotic narrowinf may have occurred without any relation with the size of EEA. All our cases were relieved by manual bougie.

[ISSN]0513-1731

[NCID]AN00243156