直肠癌术后吻合口瘘的防治进展
|
摘要
结直肠癌(colorectal cancer, CRC)是全球常见的恶性肿瘤之一,在我国其发病率和死亡率均居所有恶性肿瘤的第三位.其中直肠癌占所有CRC总发病率的60%-70%.随着对直肠癌发病机制和肿瘤转移机制的深入研究,以及手术技术方法的不断改进,中低位直肠癌保肛手术逐渐增多,患者生活质量虽然得到明显改善,但吻合口瘘仍是直肠癌保肛手术后最常见和最严重的并发症之一.研究显示直肠癌术后吻合口瘘的发生率为3%-21%,死亡率高达3%.因此,术前对患者进行全面检查,对危险因素进行综合分析,对于减少潜在吻合口瘘的风险,选择合适的手术方式和预防措施,从而有效的预防和减少吻合口瘘的发生有重要意义.本文对直肠癌术后吻合口瘘的危险因素和防治进展进行综述,以期能降低吻合口瘘的发生率.
Colorectal cancer(CRC) is one of the most commonmalignant tumors in the world, and its morbidity and mortality both rank third among all malignant tumors in China. Rectal cancer accounts for 60%-70% of cases of CRC. With the in-depth study of the pathogenesis of CRC and the mechanism of tumor metastasis, and the improvement of surgical techniques and methods, anal sphincter surgery for middle and low rectal cancer is increasing gradually. Although the quality of life of the patients improves significantly after anal sphincter preservation for rectal cancer, anastomotic leakage is still one of the most common and serious complications. Studies show that the incidence of anastomotic leakage after surgery for low rectal cancer is 3%-21%, and the death rate is up to 3%. Therefore, a comprehensive assessment of patients and analysis of risk factors before operation is of great significant for reducing the potential risk of anastomotic leakage and choosing surgical approach and appropriate preventive measures to prevent and reduce the occurrence of anastomotic leakage. In this paper, we summarize the recent research on anastomotic leakage after rectal cancer surgery in order to help other clinicians reduce the incidence of anastomotic leakage in clinical practice.
Colorectal cancer(CRC) is one of the most commonmalignant tumors in the world, and its morbidity and mortality both rank third among all malignant tumors in China. Rectal cancer accounts for 60%-70% of cases of CRC. With the in-depth study of the pathogenesis of CRC and the mechanism of tumor metastasis, and the improvement of surgical techniques and methods, anal sphincter surgery for middle and low rectal cancer is increasing gradually. Although the quality of life of the patients improves significantly after anal sphincter preservation for rectal cancer, anastomotic leakage is still one of the most common and serious complications. Studies show that the incidence of anastomotic leakage after surgery for low rectal cancer is 3%-21%, and the death rate is up to 3%. Therefore, a comprehensive assessment of patients and analysis of risk factors before operation is of great significant for reducing the potential risk of anastomotic leakage and choosing surgical approach and appropriate preventive measures to prevent and reduce the occurrence of anastomotic leakage. In this paper, we summarize the recent research on anastomotic leakage after rectal cancer surgery in order to help other clinicians reduce the incidence of anastomotic leakage in clinical practice.
引文
1王宁,孙婷婷,郑荣寿.中国2 0 0 9年结直肠癌发病和死亡资料分析.中国肿瘤2013;7:515-520[DOI:10.11735/j.issn1004-0242.2013.07.A001]
2 Sciuto A,Merola G,De Palma GD,Sodo M,Pirozzi F,Bracale UM,Bracale U.Predictive factors for anastomotic leakage after laparoscopic colorectal surgery.World J Gastroenterol2018;24:2247-2260[PMID:29881234 DOI:10.3748/wjg.v24.i21.2247]
3 Fujita F,Torashima Y,Kuroki T.Risk factors and predictive factors for anastomotic leakage after resection for colorectal cancer:reappraisal of the literature.Surg Today 2014;44:1595-1602[PMID:24006125 DOI:10.1007/s00595-013-0685-3]
4李栋梁,王明,朱俊.直肠癌前切除术后吻合口瘘相关因素分析.中华胃肠外科杂志2016;4:418-421[DOI:10.3760/cma.j.issn.1671-0274.2016.04.015]
5 Eberl T,Jagoditsch M,Klingler A,Tschmelitsch J.Risk factors for anastomotic leakage after resection for rectal cancer.Am J Surg 2008;196:592-598[PMID:18571620 DOI:10.1016/j.amjsurg.2007.10.023]
6徐谊,赵晓牧,孙武青.直肠癌低位前切除术后吻合口瘘发生相关因素分析.首都医科大学学报2017;5:727-732[DOI:10.3969/j.issn.1006-7795.2017.05.018]
7 Alberts JC,Parvaiz A,Moran BJ.Predicting risk and diminishing the consequences of anastomotic dehiscence following rectal resection.Colorectal Dis 2003;5:478-482[PMID:12925084]
8 Blumetti J,Chaudhry V,Cintron JR,Park JJ,Marecik S,Harrison JL,Prasad LM,Abcarian H.Management of anastomotic leak:lessons learned from a large colon and rectal surgery training program.World J Surg 2014;38:985-991[PMID:24305917 DOI:10.1007/s00268-013-2340-y]
9屠金金,程勇.直肠癌术后吻合口瘘原因分析及防治现状.中国普通外科杂志2010;4:422-425
10傅传刚,郝立强.低位直肠癌保肛术后吻合口漏与狭窄原因及治疗.中国实用外科杂志2014;34:851-854[DOI:10.7504/CJPS.ISSN1005-2208.2014.09.17]
11 Bruce J,Krukowski ZH,Al-Khairy G,Russell EM,Park KG.Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery.Br J Surg 2001;88:1157-1168[PMID:11531861]
12 Rahbari NN,Weitz J,Hohenberger W,Heald RJ,Moran B,Ulrich A,Holm T,Wong WD,Tiret E,Moriya Y,Laurberg S,den Dulk M,van de Velde C,Büchler MW.Definition and grading of anastomotic leakage following anterior resection of the rectum:a proposal by the International Study Group of Rectal Cancer.Surgery 2010;147:339-351[PMID:20004450DOI:10.1016/j.surg.2009.10.012]
13沈荐,李敏哲,杜燕夫.腹腔镜直肠癌低位前切除术后吻合口漏的危险因素分析.中国微创外科杂志2017;10:873-876[DOI:10.3969/j.issn.1009-6604.2017.10.003]
14李思源,赵鹏,李洪波.结直肠癌术后吻合口瘘的危险因素分析.中国现代普通外科进展2015;2:163-164[DOI:10.3969/j.issn.1009-9905.2015.02.026]
15 Lipska MA,Bissett IP,Parry BR,Merrie AE.Anastomotic leakage after lower gastrointestinal anastomosis:men are at a higher risk.ANZ J Surg 2006;76:579-585[PMID:16813622DOI:10.1111/j.1445-2197.2006.03780.x]
16李明,寇卫军,寇明文.低位直肠癌前切除术后吻合口漏的相关危险因素分析.重庆医学2017;36:5123-5125[DOI:10.3969/j.issn.1671-8348.2017.36.028]
17 Zhao WT,Hu FL,Li YY,Li HJ,Luo WM,Sun F.Use of a transanal drainage tube for prevention of anastomotic leakage and bleeding after anterior resection for rectal cancer.World J Surg 2013;37:227-232[PMID:23052807 DOI:10.1007/s00268-012-1812-9]
18 Luna P,Redriguez SE,Gutierrezdela B.Multivariate abaysis of risk factors associated with dehiscence of colorectal anastom osis after anterior or lower anterio resection for sigmoid or rectal cancer.Row Invest Clin 2002;54:501-508
19 Ionescu D,Tibrea C,Puia C.Pre-operative hypoalbuminemia in colorectal cancer patients undergoing elective surgery-a major risk factor for postoperative outcome.Chirurgia(Bucur)2013;108:822-828[PMID:24331321]
20 Zaharie F,Mocan L,Tomu?C,Mocan T,Zaharie R,Barto?D,Barto?A,Vlad L,Iancu C.Risk factors for anastomotic leakage following colorectal resection for cancer.Chirurgia(Bucur)2012;107:27-32[PMID:22480112]
21 Golub R,Golub RW,Cantu R Jr,Stein HD.A multivariate analysis of factors contributing to leakage of intestinal anastomoses.J Am Coll Surg 1997;184:364-372[PMID:9100681]
22 Law WI,Chu KW,Ho JW,Chan CW.Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision.Am J Surg 2000;179:92-96[PMID:10773140]
23 Qu H,Liu Y.Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer:a systematic review and meta-analysis.Surg Endosc 2015;29:3608-3617[PMID:25743996 DOI:10.1007/s00464-015-4117-x]
24邹科见,周卫平,李仁峰.腹腔镜直肠癌前切除术后吻合口漏危险因素的Meta分析.中华消化外科杂志2014;7:539-544[DOI:10.3760/cma.j.issn.1673-9752.2014.07.010]
25 Eriksen TF,Lassen CB,G?genur I.Treatment with corticosteroids and the risk of anastomotic leakage following lower gastrointestinal surgery:a literature survey.Colorectal Dis 2014;16:O154-O160[PMID:24215329 DOI:10.1111/codi.12490]
26 K?ckerling F,Rose J,Schneider C,Scheidbach H,Scheuerlein H,Reymond MA,Reck T,Konradt J,Bruch HP,Zornig C,B?rlehner E,Kuthe A,Szinicz G,Richter HA,Hohenberger W.Laparoscopic colorectal anastomosis:risk of postoperative leakage.Results of a multicenter study.Laparoscopic Colorectal Surgery Study Group(LCSSG).Surg Endosc 1999;13:639-644[PMID:10384066]
27 Lopez-Kostner F,Lavery IC,Hool GR,Rybicki LA,Fazio VW.Total mesorectal excision is not necessary for cancers of the upper rectum.Surgery 1998;124:612-617;discussion 617-618[PMID:9780979]
28 Vignali A,Fazio VW,Lavery IC,Milsom JW,Church JM,Hull TL,Strong SA,Oakley JR.Factors associated with the occurrence of leaks in stapled rectal anastomoses:a review of 1,014 patients.J Am Coll Surg 1997;185:105-113[PMID:9249076]
29 Zhou JL,Shen B.Endoscopic needle knife therapy for anastomotic leakage following anterior resection for rectal cancer.Colorectal Dis 2012;14:e365-e366[PMID:22568649DOI:10.1111/j.1463-1318.2012.02879.x]
30 Gergely M.Stapling instruments for intestinal anastomosis in colorectal surgery.Br J Surg 1996;83:1796-1797[PMID:9038579]
31 Mac Rae HM,McLeod RS.Handsewn vs.stapled anastomoses in colon and rectal surgery:a meta-analysis.Dis Colon Rectum1998;41:180-189[PMID:9556242]
32 Lustosa SA,Matos D,Atallah AN,Castro AA.Stapled versus handsewn methods for colorectal anastomosis surgery:a systematic review of randomized controlled trials.Sao Paulo Med J 2002;120:132-136[PMID:12436148]
33何庆飞,靳亚勋.结直肠癌术后吻合口瘘的临床分析.中国医药指南2014;20:38-39
34 Parthasarathy M,Greensmith M,Bowers D.Risk factors for anastomotic leakage after colorectal resection:a retrospective analysis of 17 518 patients.Colorectal Dis 2017;19:288-298[PMID:27474844 DOI:10.1111/codi.13476]
35谢正勇,卿三华.结直肠癌发病率及解剖部位变化趋势.世界华人消化杂志2003;7:1050-1053[DOI:10.3969/j.issn.1009-3079.2003.07.046]
36 Grzebieniak Z,Szynglarewicz B.Anastomotic leakage following anterior resection for rectal carcinoma.Przegl Lek2006;63:543-546[PMID:17203805]
37 Kobayashi M,Mohri Y,Ohi M,Inoue Y,Araki T,Okita Y,Kusunoki M.Risk factors for anastomotic leakage and favorable antimicrobial treatment as empirical therapy for intra-abdominal infection in patients undergoing colorectal surgery.Surg Today 2014;44:487-493[PMID:23563737 DOI:10.1007/s00595-013-0575-8]
38 Eriksen MT,Wibe A,Norstein J,Haffner J,Wiig JN;Norwegian Rectal Cancer Group.Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients.Colorectal Dis 2005;7:51-57[PMID:15606585 DOI:10.1111/j.1463-1318.2004.00700.x]
39 Pettersson D,Cedermark B,Holm T,Radu C,P?hlman L,Glimelius B,Martling A.Interim analysis of the Stockholm IIItrial of preoperative radiotherapy regimens for rectal cancer.Br J Surg 2010;97:580-587[PMID:20155787 DOI:10.1002/bjs.6914]
40 Martling AL,Holm T,Rutqvist LE,Moran BJ,Heald RJ,Cedemark B.Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm.Stockholm Colorectal Cancer Study Group,Basingstoke Bowel Cancer Research Project.Lancet 2000;356:93-96[PMID:10963244]
41 Akiyoshi T,Kuroyanagi H,Oya M,Konishi T,Fukuda M,Fujimoto Y,Ueno M,Yamaguchi T,Muto T.Safety of laparoscopic total mesorectal excision for low rectal cancer with preoperative chemoradiation therapy.J Gastrointest Surg2009;13:521-525[PMID:19011946 DOI:10.1007/s11605-008-0744-z]
42顾晋,杜长征.直肠癌全系膜切除术后吻合口瘘的防治.中华胃肠外科杂志2007;5:496-499[DOI:10.3760/cma.j.issn.1671-0274.2007.05.032]
43 Taflampas P,Christodoulakis M,Tsiftsis DD.Anastomotic leakage after low anterior resection for rectal cancer:facts,obscurity,and fiction.Surg Today 2009;39:183-188[PMID:19280275 DOI:10.1007/s00595-008-3835-2]
44 Antoniou SA,Antoniou GA,Koch OO,Pointner R,Granderath FA.Laparoscopic colorectal surgery confers lower mortality in the elderly:a systematic review and metaanalysis of 66,483 patients.Surg Endosc 2015;29:322-333[PMID:24986017 DOI:10.1007/s00464-014-3672-x]
45赵日升,汪挺.微创与开放低位直肠癌前切除术后吻合口瘘的危险因素比较.中华胃肠外科杂志2015;8:796-796[DOI:10.3760/cma.j.issn.1671-0274.2015.08.025]
46张冬辉,何葵,庄哲宏.腹腔镜直肠癌前切除术学习曲线中并发吻合口瘘的原因.中南大学学报(医学版)2017;7:814-819[DOI:10.11817/j.issn.1672-7347.2017.07.012]
47 Bennis M,Parc Y,Lefevre JH,Chafai N,Attal E,Tiret E.Morbidity risk factors after low anterior resection with total mesorectal excision and coloanal anastomosis:a retrospective series of 483 patients.Ann Surg 2012;255:504-510[PMID:22281734 DOI:10.1097/SLA.0b013e31824485c4]
48 Kang CY,Halabi WJ,Chaudhry OO,Nguyen V,Ketana N,Carmichael JC,Pigazzi A,Stamos MJ,Mills S.A nationwide analysis of laparoscopy in high-risk colorectal surgery patients.J Gastrointest Surg 2013;17:382-391[PMID:23212528DOI:10.1007/s11605-012-2096-y]
49 Biondo S,Kreisler E,Millan M,Fraccalvieri D,Golda T,Frago R,Miguel B.Impact of surgical specialization on emergency colorectal surgery outcomes.Arch Surg 2010;145:79-86[PMID:20083758 DOI:10.1001/archsurg.2009.208]
50 Borowski DW,Bradburn DM,Mills SJ,Bharathan B,Wilson RG,Ratcliffe AA,Kelly SB;Northern Region Colorectal Cancer Audit Group(NORCCAG).Volume-outcome analysis of colorectal cancer-related outcomes.Br J Surg 2010;97:1416-1430[PMID:20632311 DOI:10.1002/bjs.7111]
51傅传刚,郝立强.低位直肠癌保肛术后吻合口漏与狭窄原因及治疗.中国实用外科杂志2014;9:851-854
52 S i n g h K K,A i t k e n R J.O u t c o m e i n p a t i e n t s w i t h colorectal cancer managed by surgical trainees.Br J Surg1999;86:1332-1336[PMID:10540144 DOI:10.1046/j.1365-2168.1999.01234.x]
53郑鹏,许剑民.结直肠吻合术后吻合口瘘的防治.中华胃肠外科杂志2016;4:379-382[DOI:10.3760/cma.j.issn.1671-0274.2016.04.005]
54 Kim CH,Joo JK,Kim HR,Kim YJ.The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer.J Laparoendosc Adv Surg Tech A 2014;24:543-549[PMID:25062339 DOI:10.1089/lap.2014.0039]
55 Yang L,Huang XE,Zhou JN.Risk assessment on anastomotic leakage after rectal cancer surgery:an analysis of 753 patients.Asian Pac J Cancer Prev 2013;14:4447-4453[PMID:23992018]
56 Jech B.Felberbauer FX,Herbst F.Complications of elective surgery for rectal cancer.Eur Surg 2007;39:8-14
57 Yeh CY,Changchien CR,Wang JY,Chen JS,Chen HH,Chiang JM,Tang R.Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients:a prospective study of 978 patients.Ann Surg 2005;241:9-13[PMID:15621985]
58 Ren L,Zhu D,Wei Y,Pan X,Liang L,Xu J,Zhong Y,Xue Z,Jin L,Zhan S,Niu W,Qin X,Wu Z,Wu Z.Enhanced Recovery After Surgery(ERAS)program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer:a prospective randomized controlled trial.World J Surg 2012;36:407-414[PMID:22102090 DOI:10.1007/s00268-011-1348-4]
59王锡山.直肠癌保肛系列问题探讨.实用肿瘤学杂志2006;6:480-483[DOI:10.3969/j.issn.1002-3070.2006.06.006]
60 Choi HK,Law WL,Ho JW.Leakage after resection and intraperitoneal anastomosis for colorectal malignancy:analysis of risk factors.Dis Colon Rectum 2006;49:1719-1725[PMID:17051321 DOI:10.1007/s10350-006-0703-2]
61 Buchs NC,Gervaz P,Secic M,Bucher P,Mugnier-Konrad B,Morel P.Incidence,consequences,and risk factors for anastomotic dehiscence after colorectal surgery:a prospective monocentric study.Int J Colorectal Dis 2008;23:265-270[PMID:18034250 DOI:10.1007/s00384-007-0399-3]
62 Tadros T,Wobbes T,Hendriks T.Blood transfusion impairs the healing of experimental intestinal anastomoses.Ann Surg1992;215:276-281[PMID:1543401]
63傅平,周凯,徐连强.营养风险筛查在胃肠肿瘤患者围手术期中的应用.广东医学2014;23:3681-3683
64申连东,齐文海.术前营养风险与直肠癌前切除术后吻合口漏的相关性分析.中国普外基础与临床杂志2016;23:454-457
65 Yang L,Huang XE,Xu L,Zhou X,Zhou JN,Yu DS,Li DZ,Guan X.Acidic pelvic drainage as a predictive factor for anastomotic leakage after surgery for patients with rectal cancer.Asian Pac J Cancer Prev 2013;14:5441-5447[PMID:24175840]
66 Elleb?k M,Qvist N.Early detection and the prevention of serious complications of anastomotic leakage in rectal cancer surgery.Tech Coloproctol 2014;18:1-2[PMID:23633242 DOI:10.1007/s10151-013-1025-8]
67高俊,邱秀娟,王琦三.营养风险筛查对胃癌手术并发症发生率的预测价值.中国肿瘤临床2015;5:271-276[DOI:10.3969/j.issn.1000-8179.20142011]
68韩东,贺军,黄秋林.三种术前营养评价方法对消化道恶性肿瘤患者术后并发症预测价值比较.中华胃肠外科杂志2013;11:1067-1072[DOI:10.3760/cma.j.issn.1671-0274.2013.11.012]
69梁珣,徐桂华.营养风险筛查2002和患者总体主观评分法在食管癌术前患者中的应用.中国实用护理杂志2013;22:27-29[DOI:10.3760/cma.j.issn.1672-7088.2013.22.013]
70 MacDermid E,Young CJ,Young J,Solomon M.Decisionmaking in rectal surgery.Colorectal Dis 2014;16:203-208[PMID:24521275 DOI:10.1111/codi.12487]
71 Dekker JW,Liefers GJ,de Mol van Otterloo JC,Putter H,Tollenaar RA.Predicting the risk of anastomotic leakage in left-sided colorectal surgery using a colon leakage score.JSurg Res 2011;166:e27-e34[PMID:21195424 DOI:10.1016/j.jss.2010.11.004]
72喻学桥,周卫平,蔡国豪.结直肠漏评分系统预测左侧结直肠切除术后吻合口漏的分析.中华普通外科杂志2015;6:447-450[DOI:10.3760/cma.j.issn.1007-631X.2015.06.007]
73李良,杨任保,江鸣.结直肠漏评分系统在左半结肠直肠癌切除术后吻合口漏预测中的应用价值.中国普外基础与临床杂志2016;23:1370
74胡海,燕锦,刘超.左半结肠术后吻合口漏预测评分系统在腹腔镜直肠癌手术中的应用价值.浙江医学2017;17:1413-1416;1420[DOI:10.12056/j.issn.1006-2785.2017.39.17.2017-1704]
75李世邦,刘牧林,孔令尚.我国直肠癌前切除术后发生吻合口瘘危险因素的Meta分析.中华普通外科学文献(电子版)2013;3:222-230[DOI:10.3877/cma.j.issn.1647-0793.2013.03.015]
76 Wu SW,Ma CC,Yang Y.Role of protective stoma in low anterior resection for rectal cancer:a meta-analysis.World J Gastroenterol 2014;20:18031-18037[PMID:25548503 DOI:10.3748/wjg.v20.i47.18031]
77 Son DN,Choi DJ,Woo SU,Kim J,Keom BR,Kim CH,Baek SJ,Kim SH.Relationship between diversion colitis and quality of life in rectal cancer.World J Gastroenterol 2013;19:542-549[PMID:23382634 DOI:10.3748/wjg.v19.i4.542]
78 Peeters KC,Tollenaar RA,Marijnen CA,Klein Kranenbarg E,Steup WH,Wiggers T,Rutten HJ,van de Velde CJ;Dutch Colorectal Cancer Group.Risk factors for anastomotic failure after total mesorectal excision of rectal cancer.Br J Surg 2005;92:211-216[PMID:15584062 DOI:10.1002/bjs.4806]
79 Matthiessen P,Hallb??k O,Andersson M,Ruteg?rd J,Sj?dahl R.Risk factors for anastomotic leakage after anterior resection of the rectum.Colorectal Dis 2004;6:462-469[PMID:15521937DOI:10.1111/j.1463-1318.2004.00657.x]
80 Enker WE,Merchant N,Cohen AM,Lanouette NM,Swallow C,Guillem J,Paty P,Minsky B,Weyrauch K,Quan SH.Safety and efficacy of low anterior resection for rectal cancer:681consecutive cases from a specialty service.Ann Surg 1999;230:544-552;discussion 552-554[PMID:10522724]
81吴文铭,肖毅,邱辉忠.中低位直肠癌手术后吻合口瘘与预防性造口.中华胃肠外科杂志2010;6:474-476[DOI:10.3760/cma.j.issn.1671-0274.2010.06.030]
82 Pakkastie TE,Ovaska JT,Pekkala ES,Luukkonen PE,J?rvinen HJ.A randomised study of colostomies in low colorectal anastomoses.Eur J Surg 1997;163:929-933[PMID:9449446]
83 Matthiessen P,Hallb??k O,Ruteg?rd J,Simert G,Sj?dahl R.Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer:a randomized multicenter trial.Ann Surg 2007;246:207-214[PMID:17667498 DOI:10.1097/SLA.0b013e3180603024]
84 Chude GG,Rayate NV,Patris V,Koshariya M,Jagad R,Kawamoto J,Lygidakis NJ.Defunctioning loop ileostomy with low anterior resection for distal rectal cancer:should we make an ileostomy as a routine procedure?A prospective randomized study.Hepatogastroenterology 2008;55:1562-1567[PMID:19102343]
85 Hanna MH,Vinci A,Pigazzi A.Diverting ileostomy in colorectal surgery:when is it necessary?Langenbecks Arch Surg 2015;400:145-152[PMID:25633276 DOI:10.1007/s00423-015-1275-1]
86 Tsunoda A,Tsunoda Y,Narita K,Watanabe M,Nakao K,Kusano M.Quality of life after low anterior resection and temporary loop ileostomy.Dis Colon Rectum 2008;51:218-222[PMID:18172730 DOI:10.1007/s10350-007-9101-7]
87李薇,于威,刘铜军.临时回肠造口在预防低位直肠癌术后吻合口瘘中的应用价值.中华普通外科杂志2016;1:64-65[DOI:10.3760/cma.j.issn.1007-631X.2016.01.020]
88 Klink CD,Lioupis K,Binneb?sel M,Kaemmer D,Kozubek I,Grommes J,Neumann UP,Jansen M,Willis S.Diversion stoma after colorectal surgery:loop colostomy or ileostomy?Int J Colorectal Dis 2011;26:431-436[PMID:21221605 DOI:10.1007/s00384-010-1123-2]
89王新,周建平,张丹华.直肠癌术后发生吻合口瘘危险因素分析(附506例报告).中国实用外科杂志2014;9:876-879
90曹海生,任元满,彭文岗.预防性横结肠造瘘对直肠低位前切除术吻合口瘘的影响.中国普通外科杂志2010;4:343-345
91 Daams F,Luyer M,Lange JF.Colorectal anastomotic leakage:aspects of prevention,detection and treatment.World JGastroenterol 2013;19:2293-2297[PMID:23613621 DOI:10.3748/wjg.v19.i15.2293]
92吴红杰,邹小明.结直肠癌术后吻合口瘘的诊治及预防.中华结直肠疾病电子杂志2016;2:171-174[DOI:10.3877/cma.j.issn.2095-3224.2016.02.12]
93徐园,邵钦树,陶厚权.直肠癌前切除术后吻合口瘘24例临床分析.肿瘤学杂志2014;1:55-58[DOI:10.11735/j.issn.1671-170X.2014.01.B012]
2 Sciuto A,Merola G,De Palma GD,Sodo M,Pirozzi F,Bracale UM,Bracale U.Predictive factors for anastomotic leakage after laparoscopic colorectal surgery.World J Gastroenterol2018;24:2247-2260[PMID:29881234 DOI:10.3748/wjg.v24.i21.2247]
3 Fujita F,Torashima Y,Kuroki T.Risk factors and predictive factors for anastomotic leakage after resection for colorectal cancer:reappraisal of the literature.Surg Today 2014;44:1595-1602[PMID:24006125 DOI:10.1007/s00595-013-0685-3]
4李栋梁,王明,朱俊.直肠癌前切除术后吻合口瘘相关因素分析.中华胃肠外科杂志2016;4:418-421[DOI:10.3760/cma.j.issn.1671-0274.2016.04.015]
5 Eberl T,Jagoditsch M,Klingler A,Tschmelitsch J.Risk factors for anastomotic leakage after resection for rectal cancer.Am J Surg 2008;196:592-598[PMID:18571620 DOI:10.1016/j.amjsurg.2007.10.023]
6徐谊,赵晓牧,孙武青.直肠癌低位前切除术后吻合口瘘发生相关因素分析.首都医科大学学报2017;5:727-732[DOI:10.3969/j.issn.1006-7795.2017.05.018]
7 Alberts JC,Parvaiz A,Moran BJ.Predicting risk and diminishing the consequences of anastomotic dehiscence following rectal resection.Colorectal Dis 2003;5:478-482[PMID:12925084]
8 Blumetti J,Chaudhry V,Cintron JR,Park JJ,Marecik S,Harrison JL,Prasad LM,Abcarian H.Management of anastomotic leak:lessons learned from a large colon and rectal surgery training program.World J Surg 2014;38:985-991[PMID:24305917 DOI:10.1007/s00268-013-2340-y]
9屠金金,程勇.直肠癌术后吻合口瘘原因分析及防治现状.中国普通外科杂志2010;4:422-425
10傅传刚,郝立强.低位直肠癌保肛术后吻合口漏与狭窄原因及治疗.中国实用外科杂志2014;34:851-854[DOI:10.7504/CJPS.ISSN1005-2208.2014.09.17]
11 Bruce J,Krukowski ZH,Al-Khairy G,Russell EM,Park KG.Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery.Br J Surg 2001;88:1157-1168[PMID:11531861]
12 Rahbari NN,Weitz J,Hohenberger W,Heald RJ,Moran B,Ulrich A,Holm T,Wong WD,Tiret E,Moriya Y,Laurberg S,den Dulk M,van de Velde C,Büchler MW.Definition and grading of anastomotic leakage following anterior resection of the rectum:a proposal by the International Study Group of Rectal Cancer.Surgery 2010;147:339-351[PMID:20004450DOI:10.1016/j.surg.2009.10.012]
13沈荐,李敏哲,杜燕夫.腹腔镜直肠癌低位前切除术后吻合口漏的危险因素分析.中国微创外科杂志2017;10:873-876[DOI:10.3969/j.issn.1009-6604.2017.10.003]
14李思源,赵鹏,李洪波.结直肠癌术后吻合口瘘的危险因素分析.中国现代普通外科进展2015;2:163-164[DOI:10.3969/j.issn.1009-9905.2015.02.026]
15 Lipska MA,Bissett IP,Parry BR,Merrie AE.Anastomotic leakage after lower gastrointestinal anastomosis:men are at a higher risk.ANZ J Surg 2006;76:579-585[PMID:16813622DOI:10.1111/j.1445-2197.2006.03780.x]
16李明,寇卫军,寇明文.低位直肠癌前切除术后吻合口漏的相关危险因素分析.重庆医学2017;36:5123-5125[DOI:10.3969/j.issn.1671-8348.2017.36.028]
17 Zhao WT,Hu FL,Li YY,Li HJ,Luo WM,Sun F.Use of a transanal drainage tube for prevention of anastomotic leakage and bleeding after anterior resection for rectal cancer.World J Surg 2013;37:227-232[PMID:23052807 DOI:10.1007/s00268-012-1812-9]
18 Luna P,Redriguez SE,Gutierrezdela B.Multivariate abaysis of risk factors associated with dehiscence of colorectal anastom osis after anterior or lower anterio resection for sigmoid or rectal cancer.Row Invest Clin 2002;54:501-508
19 Ionescu D,Tibrea C,Puia C.Pre-operative hypoalbuminemia in colorectal cancer patients undergoing elective surgery-a major risk factor for postoperative outcome.Chirurgia(Bucur)2013;108:822-828[PMID:24331321]
20 Zaharie F,Mocan L,Tomu?C,Mocan T,Zaharie R,Barto?D,Barto?A,Vlad L,Iancu C.Risk factors for anastomotic leakage following colorectal resection for cancer.Chirurgia(Bucur)2012;107:27-32[PMID:22480112]
21 Golub R,Golub RW,Cantu R Jr,Stein HD.A multivariate analysis of factors contributing to leakage of intestinal anastomoses.J Am Coll Surg 1997;184:364-372[PMID:9100681]
22 Law WI,Chu KW,Ho JW,Chan CW.Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision.Am J Surg 2000;179:92-96[PMID:10773140]
23 Qu H,Liu Y.Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer:a systematic review and meta-analysis.Surg Endosc 2015;29:3608-3617[PMID:25743996 DOI:10.1007/s00464-015-4117-x]
24邹科见,周卫平,李仁峰.腹腔镜直肠癌前切除术后吻合口漏危险因素的Meta分析.中华消化外科杂志2014;7:539-544[DOI:10.3760/cma.j.issn.1673-9752.2014.07.010]
25 Eriksen TF,Lassen CB,G?genur I.Treatment with corticosteroids and the risk of anastomotic leakage following lower gastrointestinal surgery:a literature survey.Colorectal Dis 2014;16:O154-O160[PMID:24215329 DOI:10.1111/codi.12490]
26 K?ckerling F,Rose J,Schneider C,Scheidbach H,Scheuerlein H,Reymond MA,Reck T,Konradt J,Bruch HP,Zornig C,B?rlehner E,Kuthe A,Szinicz G,Richter HA,Hohenberger W.Laparoscopic colorectal anastomosis:risk of postoperative leakage.Results of a multicenter study.Laparoscopic Colorectal Surgery Study Group(LCSSG).Surg Endosc 1999;13:639-644[PMID:10384066]
27 Lopez-Kostner F,Lavery IC,Hool GR,Rybicki LA,Fazio VW.Total mesorectal excision is not necessary for cancers of the upper rectum.Surgery 1998;124:612-617;discussion 617-618[PMID:9780979]
28 Vignali A,Fazio VW,Lavery IC,Milsom JW,Church JM,Hull TL,Strong SA,Oakley JR.Factors associated with the occurrence of leaks in stapled rectal anastomoses:a review of 1,014 patients.J Am Coll Surg 1997;185:105-113[PMID:9249076]
29 Zhou JL,Shen B.Endoscopic needle knife therapy for anastomotic leakage following anterior resection for rectal cancer.Colorectal Dis 2012;14:e365-e366[PMID:22568649DOI:10.1111/j.1463-1318.2012.02879.x]
30 Gergely M.Stapling instruments for intestinal anastomosis in colorectal surgery.Br J Surg 1996;83:1796-1797[PMID:9038579]
31 Mac Rae HM,McLeod RS.Handsewn vs.stapled anastomoses in colon and rectal surgery:a meta-analysis.Dis Colon Rectum1998;41:180-189[PMID:9556242]
32 Lustosa SA,Matos D,Atallah AN,Castro AA.Stapled versus handsewn methods for colorectal anastomosis surgery:a systematic review of randomized controlled trials.Sao Paulo Med J 2002;120:132-136[PMID:12436148]
33何庆飞,靳亚勋.结直肠癌术后吻合口瘘的临床分析.中国医药指南2014;20:38-39
34 Parthasarathy M,Greensmith M,Bowers D.Risk factors for anastomotic leakage after colorectal resection:a retrospective analysis of 17 518 patients.Colorectal Dis 2017;19:288-298[PMID:27474844 DOI:10.1111/codi.13476]
35谢正勇,卿三华.结直肠癌发病率及解剖部位变化趋势.世界华人消化杂志2003;7:1050-1053[DOI:10.3969/j.issn.1009-3079.2003.07.046]
36 Grzebieniak Z,Szynglarewicz B.Anastomotic leakage following anterior resection for rectal carcinoma.Przegl Lek2006;63:543-546[PMID:17203805]
37 Kobayashi M,Mohri Y,Ohi M,Inoue Y,Araki T,Okita Y,Kusunoki M.Risk factors for anastomotic leakage and favorable antimicrobial treatment as empirical therapy for intra-abdominal infection in patients undergoing colorectal surgery.Surg Today 2014;44:487-493[PMID:23563737 DOI:10.1007/s00595-013-0575-8]
38 Eriksen MT,Wibe A,Norstein J,Haffner J,Wiig JN;Norwegian Rectal Cancer Group.Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients.Colorectal Dis 2005;7:51-57[PMID:15606585 DOI:10.1111/j.1463-1318.2004.00700.x]
39 Pettersson D,Cedermark B,Holm T,Radu C,P?hlman L,Glimelius B,Martling A.Interim analysis of the Stockholm IIItrial of preoperative radiotherapy regimens for rectal cancer.Br J Surg 2010;97:580-587[PMID:20155787 DOI:10.1002/bjs.6914]
40 Martling AL,Holm T,Rutqvist LE,Moran BJ,Heald RJ,Cedemark B.Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm.Stockholm Colorectal Cancer Study Group,Basingstoke Bowel Cancer Research Project.Lancet 2000;356:93-96[PMID:10963244]
41 Akiyoshi T,Kuroyanagi H,Oya M,Konishi T,Fukuda M,Fujimoto Y,Ueno M,Yamaguchi T,Muto T.Safety of laparoscopic total mesorectal excision for low rectal cancer with preoperative chemoradiation therapy.J Gastrointest Surg2009;13:521-525[PMID:19011946 DOI:10.1007/s11605-008-0744-z]
42顾晋,杜长征.直肠癌全系膜切除术后吻合口瘘的防治.中华胃肠外科杂志2007;5:496-499[DOI:10.3760/cma.j.issn.1671-0274.2007.05.032]
43 Taflampas P,Christodoulakis M,Tsiftsis DD.Anastomotic leakage after low anterior resection for rectal cancer:facts,obscurity,and fiction.Surg Today 2009;39:183-188[PMID:19280275 DOI:10.1007/s00595-008-3835-2]
44 Antoniou SA,Antoniou GA,Koch OO,Pointner R,Granderath FA.Laparoscopic colorectal surgery confers lower mortality in the elderly:a systematic review and metaanalysis of 66,483 patients.Surg Endosc 2015;29:322-333[PMID:24986017 DOI:10.1007/s00464-014-3672-x]
45赵日升,汪挺.微创与开放低位直肠癌前切除术后吻合口瘘的危险因素比较.中华胃肠外科杂志2015;8:796-796[DOI:10.3760/cma.j.issn.1671-0274.2015.08.025]
46张冬辉,何葵,庄哲宏.腹腔镜直肠癌前切除术学习曲线中并发吻合口瘘的原因.中南大学学报(医学版)2017;7:814-819[DOI:10.11817/j.issn.1672-7347.2017.07.012]
47 Bennis M,Parc Y,Lefevre JH,Chafai N,Attal E,Tiret E.Morbidity risk factors after low anterior resection with total mesorectal excision and coloanal anastomosis:a retrospective series of 483 patients.Ann Surg 2012;255:504-510[PMID:22281734 DOI:10.1097/SLA.0b013e31824485c4]
48 Kang CY,Halabi WJ,Chaudhry OO,Nguyen V,Ketana N,Carmichael JC,Pigazzi A,Stamos MJ,Mills S.A nationwide analysis of laparoscopy in high-risk colorectal surgery patients.J Gastrointest Surg 2013;17:382-391[PMID:23212528DOI:10.1007/s11605-012-2096-y]
49 Biondo S,Kreisler E,Millan M,Fraccalvieri D,Golda T,Frago R,Miguel B.Impact of surgical specialization on emergency colorectal surgery outcomes.Arch Surg 2010;145:79-86[PMID:20083758 DOI:10.1001/archsurg.2009.208]
50 Borowski DW,Bradburn DM,Mills SJ,Bharathan B,Wilson RG,Ratcliffe AA,Kelly SB;Northern Region Colorectal Cancer Audit Group(NORCCAG).Volume-outcome analysis of colorectal cancer-related outcomes.Br J Surg 2010;97:1416-1430[PMID:20632311 DOI:10.1002/bjs.7111]
51傅传刚,郝立强.低位直肠癌保肛术后吻合口漏与狭窄原因及治疗.中国实用外科杂志2014;9:851-854
52 S i n g h K K,A i t k e n R J.O u t c o m e i n p a t i e n t s w i t h colorectal cancer managed by surgical trainees.Br J Surg1999;86:1332-1336[PMID:10540144 DOI:10.1046/j.1365-2168.1999.01234.x]
53郑鹏,许剑民.结直肠吻合术后吻合口瘘的防治.中华胃肠外科杂志2016;4:379-382[DOI:10.3760/cma.j.issn.1671-0274.2016.04.005]
54 Kim CH,Joo JK,Kim HR,Kim YJ.The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer.J Laparoendosc Adv Surg Tech A 2014;24:543-549[PMID:25062339 DOI:10.1089/lap.2014.0039]
55 Yang L,Huang XE,Zhou JN.Risk assessment on anastomotic leakage after rectal cancer surgery:an analysis of 753 patients.Asian Pac J Cancer Prev 2013;14:4447-4453[PMID:23992018]
56 Jech B.Felberbauer FX,Herbst F.Complications of elective surgery for rectal cancer.Eur Surg 2007;39:8-14
57 Yeh CY,Changchien CR,Wang JY,Chen JS,Chen HH,Chiang JM,Tang R.Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients:a prospective study of 978 patients.Ann Surg 2005;241:9-13[PMID:15621985]
58 Ren L,Zhu D,Wei Y,Pan X,Liang L,Xu J,Zhong Y,Xue Z,Jin L,Zhan S,Niu W,Qin X,Wu Z,Wu Z.Enhanced Recovery After Surgery(ERAS)program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer:a prospective randomized controlled trial.World J Surg 2012;36:407-414[PMID:22102090 DOI:10.1007/s00268-011-1348-4]
59王锡山.直肠癌保肛系列问题探讨.实用肿瘤学杂志2006;6:480-483[DOI:10.3969/j.issn.1002-3070.2006.06.006]
60 Choi HK,Law WL,Ho JW.Leakage after resection and intraperitoneal anastomosis for colorectal malignancy:analysis of risk factors.Dis Colon Rectum 2006;49:1719-1725[PMID:17051321 DOI:10.1007/s10350-006-0703-2]
61 Buchs NC,Gervaz P,Secic M,Bucher P,Mugnier-Konrad B,Morel P.Incidence,consequences,and risk factors for anastomotic dehiscence after colorectal surgery:a prospective monocentric study.Int J Colorectal Dis 2008;23:265-270[PMID:18034250 DOI:10.1007/s00384-007-0399-3]
62 Tadros T,Wobbes T,Hendriks T.Blood transfusion impairs the healing of experimental intestinal anastomoses.Ann Surg1992;215:276-281[PMID:1543401]
63傅平,周凯,徐连强.营养风险筛查在胃肠肿瘤患者围手术期中的应用.广东医学2014;23:3681-3683
64申连东,齐文海.术前营养风险与直肠癌前切除术后吻合口漏的相关性分析.中国普外基础与临床杂志2016;23:454-457
65 Yang L,Huang XE,Xu L,Zhou X,Zhou JN,Yu DS,Li DZ,Guan X.Acidic pelvic drainage as a predictive factor for anastomotic leakage after surgery for patients with rectal cancer.Asian Pac J Cancer Prev 2013;14:5441-5447[PMID:24175840]
66 Elleb?k M,Qvist N.Early detection and the prevention of serious complications of anastomotic leakage in rectal cancer surgery.Tech Coloproctol 2014;18:1-2[PMID:23633242 DOI:10.1007/s10151-013-1025-8]
67高俊,邱秀娟,王琦三.营养风险筛查对胃癌手术并发症发生率的预测价值.中国肿瘤临床2015;5:271-276[DOI:10.3969/j.issn.1000-8179.20142011]
68韩东,贺军,黄秋林.三种术前营养评价方法对消化道恶性肿瘤患者术后并发症预测价值比较.中华胃肠外科杂志2013;11:1067-1072[DOI:10.3760/cma.j.issn.1671-0274.2013.11.012]
69梁珣,徐桂华.营养风险筛查2002和患者总体主观评分法在食管癌术前患者中的应用.中国实用护理杂志2013;22:27-29[DOI:10.3760/cma.j.issn.1672-7088.2013.22.013]
70 MacDermid E,Young CJ,Young J,Solomon M.Decisionmaking in rectal surgery.Colorectal Dis 2014;16:203-208[PMID:24521275 DOI:10.1111/codi.12487]
71 Dekker JW,Liefers GJ,de Mol van Otterloo JC,Putter H,Tollenaar RA.Predicting the risk of anastomotic leakage in left-sided colorectal surgery using a colon leakage score.JSurg Res 2011;166:e27-e34[PMID:21195424 DOI:10.1016/j.jss.2010.11.004]
72喻学桥,周卫平,蔡国豪.结直肠漏评分系统预测左侧结直肠切除术后吻合口漏的分析.中华普通外科杂志2015;6:447-450[DOI:10.3760/cma.j.issn.1007-631X.2015.06.007]
73李良,杨任保,江鸣.结直肠漏评分系统在左半结肠直肠癌切除术后吻合口漏预测中的应用价值.中国普外基础与临床杂志2016;23:1370
74胡海,燕锦,刘超.左半结肠术后吻合口漏预测评分系统在腹腔镜直肠癌手术中的应用价值.浙江医学2017;17:1413-1416;1420[DOI:10.12056/j.issn.1006-2785.2017.39.17.2017-1704]
75李世邦,刘牧林,孔令尚.我国直肠癌前切除术后发生吻合口瘘危险因素的Meta分析.中华普通外科学文献(电子版)2013;3:222-230[DOI:10.3877/cma.j.issn.1647-0793.2013.03.015]
76 Wu SW,Ma CC,Yang Y.Role of protective stoma in low anterior resection for rectal cancer:a meta-analysis.World J Gastroenterol 2014;20:18031-18037[PMID:25548503 DOI:10.3748/wjg.v20.i47.18031]
77 Son DN,Choi DJ,Woo SU,Kim J,Keom BR,Kim CH,Baek SJ,Kim SH.Relationship between diversion colitis and quality of life in rectal cancer.World J Gastroenterol 2013;19:542-549[PMID:23382634 DOI:10.3748/wjg.v19.i4.542]
78 Peeters KC,Tollenaar RA,Marijnen CA,Klein Kranenbarg E,Steup WH,Wiggers T,Rutten HJ,van de Velde CJ;Dutch Colorectal Cancer Group.Risk factors for anastomotic failure after total mesorectal excision of rectal cancer.Br J Surg 2005;92:211-216[PMID:15584062 DOI:10.1002/bjs.4806]
79 Matthiessen P,Hallb??k O,Andersson M,Ruteg?rd J,Sj?dahl R.Risk factors for anastomotic leakage after anterior resection of the rectum.Colorectal Dis 2004;6:462-469[PMID:15521937DOI:10.1111/j.1463-1318.2004.00657.x]
80 Enker WE,Merchant N,Cohen AM,Lanouette NM,Swallow C,Guillem J,Paty P,Minsky B,Weyrauch K,Quan SH.Safety and efficacy of low anterior resection for rectal cancer:681consecutive cases from a specialty service.Ann Surg 1999;230:544-552;discussion 552-554[PMID:10522724]
81吴文铭,肖毅,邱辉忠.中低位直肠癌手术后吻合口瘘与预防性造口.中华胃肠外科杂志2010;6:474-476[DOI:10.3760/cma.j.issn.1671-0274.2010.06.030]
82 Pakkastie TE,Ovaska JT,Pekkala ES,Luukkonen PE,J?rvinen HJ.A randomised study of colostomies in low colorectal anastomoses.Eur J Surg 1997;163:929-933[PMID:9449446]
83 Matthiessen P,Hallb??k O,Ruteg?rd J,Simert G,Sj?dahl R.Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer:a randomized multicenter trial.Ann Surg 2007;246:207-214[PMID:17667498 DOI:10.1097/SLA.0b013e3180603024]
84 Chude GG,Rayate NV,Patris V,Koshariya M,Jagad R,Kawamoto J,Lygidakis NJ.Defunctioning loop ileostomy with low anterior resection for distal rectal cancer:should we make an ileostomy as a routine procedure?A prospective randomized study.Hepatogastroenterology 2008;55:1562-1567[PMID:19102343]
85 Hanna MH,Vinci A,Pigazzi A.Diverting ileostomy in colorectal surgery:when is it necessary?Langenbecks Arch Surg 2015;400:145-152[PMID:25633276 DOI:10.1007/s00423-015-1275-1]
86 Tsunoda A,Tsunoda Y,Narita K,Watanabe M,Nakao K,Kusano M.Quality of life after low anterior resection and temporary loop ileostomy.Dis Colon Rectum 2008;51:218-222[PMID:18172730 DOI:10.1007/s10350-007-9101-7]
87李薇,于威,刘铜军.临时回肠造口在预防低位直肠癌术后吻合口瘘中的应用价值.中华普通外科杂志2016;1:64-65[DOI:10.3760/cma.j.issn.1007-631X.2016.01.020]
88 Klink CD,Lioupis K,Binneb?sel M,Kaemmer D,Kozubek I,Grommes J,Neumann UP,Jansen M,Willis S.Diversion stoma after colorectal surgery:loop colostomy or ileostomy?Int J Colorectal Dis 2011;26:431-436[PMID:21221605 DOI:10.1007/s00384-010-1123-2]
89王新,周建平,张丹华.直肠癌术后发生吻合口瘘危险因素分析(附506例报告).中国实用外科杂志2014;9:876-879
90曹海生,任元满,彭文岗.预防性横结肠造瘘对直肠低位前切除术吻合口瘘的影响.中国普通外科杂志2010;4:343-345
91 Daams F,Luyer M,Lange JF.Colorectal anastomotic leakage:aspects of prevention,detection and treatment.World JGastroenterol 2013;19:2293-2297[PMID:23613621 DOI:10.3748/wjg.v19.i15.2293]
92吴红杰,邹小明.结直肠癌术后吻合口瘘的诊治及预防.中华结直肠疾病电子杂志2016;2:171-174[DOI:10.3877/cma.j.issn.2095-3224.2016.02.12]
93徐园,邵钦树,陶厚权.直肠癌前切除术后吻合口瘘24例临床分析.肿瘤学杂志2014;1:55-58[DOI:10.11735/j.issn.1671-170X.2014.01.B012]