Background. Anastomotic leakage remains a major complication of colorectal surgery. Prompt detection and immediate treatment of anastomotic leaks during surgery may reduce postoperative morbidity and mortality. The use of various intraoperative anastomotic tests has been proposed to reduce the incidence of this complication. Herein, we present our experience of conducting intraoperative dye tests in colorectal cancer surgery. Methods. Data of 111 patients who underwent colorectal cancer surgery between 2019 and 2021 at a single medical center were retrospectively reviewed, of which 88 underwent elective surgery without the creation of a diverting stoma, and 23 patients, who received a diverting stoma either previously or during the same operation, were excluded from the study. Diluted dye was routinely introduced into the rectal lumen to test anastomotic integrity. If an intraoperative leak was identified, it was promptly repaired. No routine radiological survey or intraoperative colonoscopy was conducted to assess anastomotic integrity after colorectal anastomoses. Results. Of the 88 patients, 12 (12.5%) presented anastomotic leaks, which were repaired using suture reinforcement. One of the 76 patients who had no intraoperative leaks developed clinical leaks during follow-up (leak rate: 1.3%). Of the 12 patients with intraoperative leaks, 2 developed clinical leaks during follow-up (16.6%). The overall rate of postoperative leakage was 3.4% (3/88). Conclusions. Routine use of the intraoperative dye test to detect colorectal anastomoses following colorectal surgery may be advantageous.
目的:大腸直腸癌術後吻合處滲漏都會帶來嚴重的併發症甚至提高死亡率,藉由術中滲漏測試,判斷高滲漏風險因子,藉由了解高風險病人而提早發現滲漏及提早治療減少併發症及降低死亡率,目前已經提出使用各種術中吻合試驗來減少這種並發症的發生率。在此,介紹我們在大腸直腸癌手術中進行術中染料測試的經驗。方法:藉回溯性觀察,於2019年到2021間蒐集111名在本院行大腸直腸癌手術的病患,除去術前或同次手術行腸造口之病患,共23人無須術中行染色檢測,一共分析88名患者。稀釋的染劑由肛門灌入直腸來測試吻合的完整性。如果發現術中滲漏,及時修復。沒有進行常規放射檢查或術中大腸鏡檢查來評估結直腸吻合術後的吻合的完整性。結果:在88位病患中有12位有發現術中染色滲漏之情況(12.5%)且在術中再行加強縫合,在術中滲漏為陰性的病患共有76位,在這76位當中有一位病患有術後吻合處滲漏發生(1.3%),在術中測試陽性病患共12位裡面有兩位病患發生術後吻合處滲漏(16.6%),在術後總體滲漏率是3.4%。結論:在大腸直腸癌手術中常規使用吻合處染色測試是一種有利的術後滲漏檢測。