Abstract:

Complications and countermeasures of lower rectal cancer following surgical resection        LI Ying-jie，WU Ai-wen. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education); Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute,Beijing100142
Corresponding author：WU Ai-wen，E-mail：wuaw@@sina.com
Abstract    Prevention and management of postoperative complications for low rectal cancer are essential for successful operation and good prognosis for the patients.（1）Accurate clinical evaluation should be performed before operation and reasonable treatment decision should be made. Meanwhile，individual factors of patients and tumors must be realized accurately. （2） Surgeons should always adhere to the principle of “plane first” and abide by the principle of TME for low rectal cancer. Team cooperation and anesthesia procedure should be emphasized. Capacity of handing accident events should be cultivated for the team.（3）Intraoperative incidental injuries by instruments should be avoided for example improper use of anastomosis.（4）As to the prevention and management of postoperative complications of low rectal cancer operation， prophylactic stoma may be regularly performed for low rectal cancer patients undergoing anterior resection. After sphincter-preserving surgery for low rectal cancer， attention must be paid to the occurrence of anastomotic leakage， anastomotic bleeding， anastomotic stenosis and presacral hemorrhage.

Key words: low rectal cancer, complication, surgery

摘要：

对低位直肠癌手术并发症的预防和处理关系到手术成败和病人预后。预防和处理低位直肠癌手术并发症须注意以下几点：（1）术前应进行准确的临床评估、做出合理的临床决策，也要准确了解病人及肿瘤自身等个体因素。（2）手术操作中应始终遵循平面优先的原则，并注重团队合作和重视麻醉因素，培养团队术中应对意外的能力。（3）避免器械设备因素造成术中副损伤（如吻合器使用不合理）。（4）中低位直肠癌病人在保肛手术后行预防性末端回肠造口可降低术后吻合口漏发生率。低位直肠癌保肛手术后须注意预防吻合口漏、吻合口出血、骶前出血和吻合口狭窄的发生。

关键词: 低位直肠癌, 并发症, 手术