经腹膜外隧道置管引流在直肠切除术中的研究进展

Research Progress of Extraperitoneal Tunnel Drainage in Rectal Resection

摘要: 直肠切除术后常规留置盆腔引流管，旨在引流术后积血、渗液，降低盆腔感染风险，并有助于早期发现吻合口瘘、减少二次手术干预。近年来，一些研究认为直肠切除术后留置盆腔引流管对患者无获益，然而，质疑引流管价值的研究普遍忽略了引流管移位的影响，临床上传统的置管方式引流移位率较高，引流不充分，致使引流管的实际作用可能被低估。经腹膜外隧道(EPT)置管由此发展而来，该置管方式不仅能实现引流管的长效固定，还可以减少其与腹腔脏器直接接触，在充分引流、加快胃肠功能恢复、减少术后并发症等方面可能具有更大优势。目前有关这方面的综述尚未见报道，本文就其进行综述，以期为后续的研究取得新的突破奠定良好的基础。

Abstract: Routine placement of pelvic drainage catheters after rectal resection aims to evacuate postoperative hemoperitoneum and exudate, reduce the risk of pelvic infection, facilitate early detection of anastomotic leakage, and decrease the need for re‑intervention. In recent years, several studies have suggested that pelvic drainage offers no clinical benefit for patients following rectal resection. Nevertheless, studies questioning the value of drainage catheters generally ignore the impact of catheter displacement. The conventional drainage technique is associated with a high displacement rate and inadequate drainage, which may underestimate the true clinical effect of pelvic drainage. The extraperitoneal tunnel (EPT) catheter placement technique has therefore been developed. This approach enables long‑term stable fixation of drainage catheters and reduces direct contact between catheters and intra‑abdominal viscera. It may confer superior advantages in achieving adequate drainage, accelerating the recovery of gastrointestinal function, and lowering the incidence of postoperative complications. To date, no relevant reviews focusing on this topic have been published. This article reviews the available evidence to lay a solid foundation for further innovative research in this field.