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| 1 | Anastomotic leakage in rectal cancer surgery:The role of blood perfusion显示文摘Anastomotic leakage after anterior resection for rectal cancer remains a common and often devastating complication. Preoperative risk factors for anastomotic leakage have been studied extensively and are used for patient selection, especially whether to perform a diverting stoma or not. From the current literature,data suggest that perfusion in the rectal stump rather than in the colonic limb may be more important for the integrity of the colorectal anastomosis. Moreover, available research suggests that the mid and upper rectum is considerably more vascularized than the lower part, in which the posterior compartment seems most vulnerable. These data fit neatly with the observation that anastomotic leaks are far more frequent in patients undergoing total compared to partial mesorectal excision, and also that most leaks occur dorsally. Clinical judgment has been shown to ineffectively assess anastomotic viability, while promising methods to measure blood perfusion are evolving. Much interest has recently been turned to near-infrared light technology, enhanced with fluorescent agents, which enables intraoperative perfusion assessment. Preliminary data are promising, but large-scale controlled trials are lacking. With maturation of such technology, perfusion measurements may in the future inform the surgeon whether anastomoses are at risk. In high colorectal anastomoses, anastomotic revision might be feasible, while a diverting stoma could be fashioned selectively instead of routinely for low anastomoses. | Martin Rutegard Jorgen Rutegard | 2015 | World Journal of Gastrointestinal Surgery2015，7，11： | 10 |
| 2 | 吻合口漏:预防、诊断及治疗显示文摘引言:在直肠癌的治疗方法中,手术切除仍是治疗直肠癌的主要手段。腹腔镜、吻合器的应用明显提高了保肛率。然而吻合口漏仍是最令病人及外科医生烦恼的并发症之一[1],因此,有效地预防及恰当地处理吻合口漏显得尤为重要。现从吻合口漏的诊断、及治疗等方面的现状及进展做一综述。1.吻合口漏的表现及诊断吻合口漏通常在术后5-8天出现典型的临床表现,但也有一些意外甚至有报道术后12天诊断为吻合口漏[2]。 | 王亚琼 禹正杨 | 2015 | 大家健康(学术版)2015，，5： | 0 |
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