关键词: 直肠肿瘤, 吻合口漏, 对策

Abstract: Preventive strategies to reduce the incidence of anastomotic leakage after radical resection of rectal cancer        JING Chang-qing, CHEN Yue-zhi,TIAN Feng,et al. Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
Corresponding author: JING Chang-qing, E-mail：jing66510122@sina.com
Abstract    Anastomotic leakage is one of the most common postoperative complications of rectal cancer. With the continuous improvement of surgical techniques，surgical instruments and perioperative management，rectal surgery is becoming more and more minimally invasive，precise and accurate. The rate of anal sphincter preservation for rectal cancer is increasing，but the incidence of anastomotic leakage has not decreased significantly.The reason is that there may be various risk factors for anastomotic leakage，and the prevention of one or more of them alone cannot reduce the incidence of anastomotic leakage. Therefore，it is very important to forward individualized preventive measures for various risk factors related to anastomotic leakage in preoperative，intraoperative and postoperative period.For instance，actively correct and improve general conditions such as hypoproteinemia，anemia，hyperglycemia and strictly stop smoking and drinking before surgery.Maintain high-quality surgical procedures during the operation，and appropriate preventive measures should be selected according to the location of tumor，whether new adjuvant treatment has been done or not.Finally，it should try to prevent long-term hypoxemia and correct early diarrhea after surgery as well as strengthen monitoring and observation for early diagnosis and early treatment.The prevention strategy of anastomotic leakage should run throughout the perioperative period.Only comprehensive prevention and individualized treatment can reduce the occurrence of leakage after anastomosis.

Key words: rectal neoplasms, anastomotic leakage, strategy