摘要
目的归纳分析直肠癌患者接受腹腔镜下直肠癌根治术后出现吻合口漏的相关危险因素。方法选择2020年2月—2023年2月苏北人民医院收诊治疗的直肠癌患者300例作为研究对象,均采取腹腔镜下直肠癌根治术治疗,按照术后患者有无出现吻合口漏情况进行分组,归纳分析诱发吻合口漏的相关危险因素,进行单因素和多因素分析。结果300例直肠癌患者经腹腔镜根治术后,发生吻合口漏患者总13例,发生率为4.33%,根据单因素分析结果显示,发生吻合口漏的患者中,男性、体质量指数(body mass index,BMI)>25 kg/m^(2)、术前血清白蛋白<30 g/L、手术时间≥4 h、距肛缘距离≤5 cm、术前合并糖尿病、接受新辅助化疗的患者占比明显高于未发生吻合口漏的患者(P<0.05),而两组患者年龄≥65岁、病理分期、肿瘤大小比较无统计学差异(P>0.05)。多因素分析结果显示,患者性别、糖尿病、BMI>25 kg/m^(2)、术前血清白蛋白水平<30 g/L、手术时间≥4 h、距肛缘距离≤5 cm、术前新辅助放化疗均为发生术后吻合口漏的独立危险因素。结论直肠癌患者接受腹腔镜下直肠癌根治术,多种因素可引起吻合口漏的发生,应针对性予以预防,保障手术质量,促进患者术后恢复。
Objective To summarize the risk factors of anastomotic leakage in rectal cancer patients after laparoscopic radical rectal cancer treatment.Methods A total of 300 patients with rectal cancer admitted and treated in North Subei People's Hospital from February 2020 to February 2023 were selected as the study subjects,all of whom were treated with laparoscopic radical resection for rectal cancer.The patients were grouped according to whether they had anastomotic leakage after surgery.The related risk factors for inducing anastomotic leakage were summarized,and univariate and multivariate analyses were conducted.Results After 300 patients with rectal cancer were treated by laparoscopic radical resection,anastomotic leakage occurred in a total of 13 patients,and the incidence rate was 4.33%.According to the results of the univariate analysis,in patients with anastomotic leakage,the proportions of male,body mass index(BMI)>25 kg/m^(2),preoperative serum albumin<30 g/L,surgery time≥4 h,≤5 cm from the anal margin,preoperative diabetes,and preoperative neoadjuvant chemotherapy were significantly higher than those in patients without anastomotic leakage(P<0.05).However,there were no statistical differences between the groups of≥65 years old,different pathological stages and tumor sizes(P>0.05).According to the results of multivariate analysis,gender,diabetes,BMI over 25 kg/m 2,preoperative serum albumin level<30 g/L,operation time≥4 h,≤5 cm away from the anal margin,and preoperative neoadjuvant chemoradiotherapy were all independent risk factors affecting postoperative anastomotic leakage.Conclusion During the treatment of laparoscopic radical resection of rectal cancer in patients,many factors can induce the complication of anastomotic leakage,which should be targeted to ensure the quality of surgery and promote the postoperative recovery of patients.
作者
潘燕南
陆学安
李瑞奇
王伟
汪刘华
王勇
王道荣
PAN Yannan;LU Xue’an;LI Ruiqi;WANG Wei;WANG Liuhua;WANG Yong;WANG Daorong(Medical School of Yangzhou University,Yangzhou,Jiangsu 225002,China;Yangzhou University Clinical Hospital,Yangzhou,Jiangsu 225002,China;Department of General Surgery,Donghai County People's Hospital,Lianyungang,Jiangsu 222300,China;Subei People's Hospital,Medical College of Nanjing University Teaching Hospital,Yangzhou,Jiangsu 225001,China;Yangzhou University-Yangzhou Municipal Institute of General Surgery,Yangzhou,Jiangsu 225002,China;Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive/Metabolic Diseases,Yangzhou,Jiangsu 225002,China)
出处
《手术电子杂志》
2023年第4期54-59,共6页
Electronic Journal of Medical Operations
基金
扬州市消化病/代谢病基础与临床转化重点实验室(YZ2020159)
关键词
腹腔镜
直肠癌根治术
吻合口漏
危险因素
laparoscopy
radical resection of rectal cancer
anastomotic leakage
risk factors
