黏膜内pH测定对结肠直肠癌术后吻合口漏的早期预测

作     者：Millan M. Garca-Granero E. Flor B. 刘丽娜 

作者机构：Avda Primado Reig 58-15Valencia46010Spain.Dr 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第10期

页      面：11-12页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：结肠直肠癌 pH 术后吻合口 早期预测 吻合口漏 结肠直肠吻合术 张力测定法 乙状结肠癌 风险度 单 

摘      要：PURPOSE:Adequate oxygenation is necessary for anastomotic healing, and ischemia has been found to be one of the most important factors in anastomotic leakage. This study was designed to assess the value of early postoperative intramucosal pH measurements for the prediction of anastomotic leakage in patients with colorectal anastomosis. METHODS: A prospective study of 90 patients with rectal or sigmoid cancer with primary anastomosis was conducted. In all patients intramucosal pH was determined by using tonometry at the anastomotic and gastric levels during the first 24 and 48 hours postoperatively. Seven other variables also were tested by univariate and multivariate analysis for any association with anastomotic leakage. RESULTS: The rate of clinical anastomotic leakage was 6.6 percent. Multivariate analysis showed that only the intramucosal pH at the anastomosis was an independent factor for the development of anastomotic leakage. The risk of leakage was 22 times higher in patients with an anastomotic intramucosal pH 7.28 in the first 24 hours after surgery. CONCLUSIONS: Measurement of anastomotic intramucosal pH in the early postoperative period can more accurately predict the risk of anastomotic leakage and benefit those patients who would need additional measures to improve the viability of the anastomosis.