探索硬质直肠镜经肛门精准评估及引导置管治疗直肠低位吻合口漏的微创治疗方法。

回顾性分析2019年8月至2022年12月用前列腺电切镜对直肠癌Dixon术后8例临床症状严重的低位直肠吻合口漏进行评估治疗的患者资料，按国际直肠癌协作组（ISREC）分级标准进行分级：B级1例，C级7例，在电切镜监视引导下，实施“3管4腔置管引流法”，彻底冲洗清除骶前及直肠周围残腔内残留的肠内容物、坏死组织、异物等，监测患者吻合口漏的情况及感染相关指标，评估该方法临床疗效。

8例患者用前列腺电切镜经肛门精准评估并置管引流治疗后6例痊愈出院，平均愈合时间13（9~18）d。1例因出现吻合口出血及直肠阴道瘘，1例因吻合口完全离断、回缩当即行永久性降结肠造瘘。本组病例全部治愈，无1例死亡。

将前列腺电切镜作为冲洗式直肠镜精准评估及引导置管引流治疗直肠低位吻合口漏是一种安全、便捷、有效、微创的治疗方法。

To explore a minimally invasive method for the treatment of low rectal anastomotic leakage by rigid proctoscopy and guided catheterization through anus.

Data of 8 patients with severe clinical symptoms of low rectal anastomotic leakage after Dixon rectal cancer were evaluated and treated by electroprostatoscopy from August 2019 to December 2022, and were graded according to the International Rectal Cancer Collaboration Group (ISREC) grading criteria: 1 case of grade B and 7 cases of grade C were monitored and guided by the electric incision microscope, "3 tubes and 4 cavities catheter drainage" was performed, and the residual intestinal contents, necrotic tissue, and foreign bodies in the anterior sacral and perirectal residual cavities were thoroughly washed away. The situation of anastomotic leakage and infection-related indicators of the patients were monitored, and the clinical efficacy of this method was evaluated.

8 patients were treated with electroprostatoscope and catheterization and drainage. 6 patients were cured and discharged. The average healing time was 13 (9~18) days. Anastomotic hemorrhage and rectovaginal fistula occurred in 1 case, and permanent descending colostomy occurred immediately in 1 case due to complete anastomotic rupture and retraction. All cases were cured and no one died.

It is a safe, convenient, effective and minimally invasive treatment method to use electroprostatoscope as flush proctoscope to accurately evaluate and guide catheterization and drainage for the treatment of low rectal anastomotic leakage.