Anastomotic leakage in patients with lower rectal cancer receiving preoperative neoadjuvant therapy
10.3760/cma.j.issn.1007-631X.2009.02.006
- VernacularTitle:术前经新辅助治疗的中低位直肠癌患者吻合口漏的预防和治疗
- Author:
Gonghang DONG
;
Jianping WANG
;
Yanhong DENG
;
Weixing DING
;
Ping LAN
- Publication Type:Journal Article
- Keywords:
Rectal neoplasm;
Neoadjuvant therapy;
Postoperative complications;
Anastomotic leakage
- From:
Chinese Journal of General Surgery
2009;24(2):100-102
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the prevention and management of anastomotic leakage in patients with middle and lower rectal cancer after neoadjuvant therapy.Methods In this study,50 cases of middle or lower rectal carcinoma underwent anus preserving radical resection and anastomosis after a 4 cycles of chemotherapy with FOLFOX and 46 Gy(2 Gy×23)radiotherapy.Anastomotic leakage,the prevention and management of this complication were analyzed retrospectively.Results All these 50 patients received low anterior resection after chemoradiotherapy,among the 19 cases receiving prophylactic ileac stoma simultaneously,there was no anastomotic leakage,whereas anastomotic leakage developed in 4 out of the 31 patients who did not receive prophylactic ileac stoma,including concomitant rectovaginal fistula in 2 cases.All these fistulae were cured conservatively.Conclusion Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer could increase the rate of anal interior sphincter reservation,prophylactic ileac stoma helps to reduce the rate of anastomotic leakage after a anus-preserving low anterior resection of the cancer.
