摘要
目的分析直肠癌根治术后并发症发生的危险因素，探讨高位结扎肠系膜下动脉对直肠癌术后并发症的影响。方法对2011年1月至2015年12月在川北医学院附属医院行直肠癌根治术患者的临床资料进行回顾性分析，对影响术后并发症发生的危险因素采用χ2检验或t检验进行统计学分析。结果共有431例患者行直肠癌手术，按纳入及排除标准，351例纳入研究，根据肠系膜下动脉结扎位置分为高位结扎组196例，低位结扎组155例。高位结扎组和低位结扎组术后并发症的总发生率比较，差异无统计学意义[20.4%（40/196）比27.1%（42/155），χ2=1.336，P=0.245]；两组吻合口瘘发生率比较，差异无统计学意义[10.2%（20/196）比7.7%（12/155），χ2=0.529，P=0.467]。logistic回归分析结果显示：性别（OR=2.102，95% CI 1.278-3.459，P=0.003）、体质量指数（OR=2.492，95% CI 1.070-5.800，P=0.027）、术前是否贫血（OR=2.203，95% CI 1.085-4.472，P=0.029）和肿瘤位置（OR=2.861，95% CI 1.288-16.007，P=0.019）是直肠癌根治术后发生吻合口瘘的独立危险因素。结论高位结扎肠系膜下动脉未增加直肠癌根治术后并发症。性别、体质量指数、术前是否贫血和肿瘤位置为影响直肠癌根治术后吻合口瘘发生的危险因素。
ObjectiveTo identify the risk factors for postoperative complications after radical resection of rectal cancer, and study the influence of high ligation of the inferior mesenteric artery on postoperative complications of rectal cancer.
MethodsClinical data of the patients who underwent radical resection of rectal cancer in the Affiliated Hospital of North Sichuan Medical College from January 2011 to December 2015 were analyzed. The χ2 test and t test were used for all the data.
ResultsA total of 431 patients with rectal cancer were included, of which 80 cases were excluded, and finally 351 cases met the standard. Among them, 196 cases were in high ligation group, and 155 cases were in low ligation group. The total incidence of postoperative complications was 20.4% （40/196） in the high ligation group and 27.1% （42/155） in the low ligation group respectively, the difference of which was not statistically significant （χ2 = 1.336, P = 0.245）. The incidence of anastomotic leakage was 10.2% （20/196） in the high ligation group and 7.7% （12/155） in the low ligation group respectively, and there was no significant difference between them （χ2 = 0.529, P = 0.467）. Logistic regression analysis revealed that gender （OR = 2.102, 95% CI 1.278-3.459, P = 0.003）, body mass index （OR = 2.492, 95% CI 1.070-5.800, P = 0.027）, with or without anemia before surgery （OR = 2.203, 95% CI 1.085-4.472, P = 0.029）, and location of tumor （OR = 2.861, 95% CI 1.288-16.007, P = 0.019） were independent risk factors for postoperative complications.ConclusionsHigh ligation of the inferior mesenteric artery does not increase the incidence of postoperative complications after radical resection of rectal cancer. Anastomotic leakage after rectal cancer resection is related to gender, body mass index, with or without anemia before surgery, and location of tumor.
作者
刘作良
谢雪虹
田洪鹏
侯华芳
张广军
李利发
周彤
Liu Zuoliang;Xie Xuehong;Tian Hongpeng;Hou Huafang;Zhang Guangjun;Li Lifo;Zhou Tong(Department of Gastrointestinal Surgery 2, Institute of Hepatobiliary, Pancreas and Intestinal Disease, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Chin)
出处
《肿瘤研究与临床》
CAS
2018年第5期303-307,311,共6页
Cancer Research and Clinic
关键词
直肠肿瘤
腹腔镜
肠系膜下动脉
吻合口瘘
Rectal neoplasms
Laparoscopic
Inferior mesenteric artery
Anastomotic leakage
