关键词: 放疗, 直肠癌, 吻合口, 并发症, 代直肠切除重建手术

Abstract: Surgical prevention and treatment of radiation-related rectal anastomotic complications        HUANG Bin-jie, QIN Qi-yuan, MA Teng-hui. Department of General Surgery (Colorectal Surgery & Radiation Intestinal Injury Center), Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Biomedical Innovation Center; Department of Clinical Nutrition and Microbiome, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
Corresponding author: MA Teng-hui,E-mail:matengh@mail.sysu.edu.cn
Abstract    Neoadjuvant radiotherapy is an important treatment modality for locally advanced rectal cancer. It increases the rate of sphincter preservation and improves oncological prognosis. However, it can also increase the risk of postoperative complications such as anastomotic leakage and stenosis, which may be related to radiation damage at both ends of the anastomosis. Patients who developed radiation-related rectal anastomotic complications were at a higher risk of permanent colostomy and poor anal-rectal function, which might significantly affect patients’ quality of life. Proximal extended resection ensures at least one side of the bowel is healthy and can significantly reduce the risk of radiation-related rectal anastomotic complications. For patients who have already developed radiation-related anastomotic complications and conservative treatment is ineffective, laparoscopic rectal-sigmoid colon extended resection with colon anal pull-through (PE-Bacon) can be used to do anastomosis redo surgery after careful patient selection.

Key words: radiotherapy, rectal carcinoma;anastomosis;complication, anastomosis redo surgery