摘要
目的探讨腹腔镜腹会阴联合切除术治疗低位直肠癌手术难度的影响因素。方法回顾性分析91例行腹腔镜腹会阴联合切除术的低位直肠癌患者的临床病理资料,采用单因素分析和Logistic回归分析,筛选可影响手术时间、术中失血量及术后并发症发生率的因素。结果统计分析显示,体质量指数(BMI)(OR=12.85,P=0.006)、坐骨棘间径(OR=23.70,P=0.001)、肿瘤距肛缘的距离(OR=54.84,P=0.032)、腹部手术史(OR=17.5,P=0.029)、术前放化疗(OR=21.25,P=0.015)、合并基础疾病(高血压和/或糖尿病)(OR=13.61,P=0.013)是影响手术时间的独立因素。患者年龄(OR=13.14,P=0.021)和合并基础疾病(OR=25.19,P=0.046)是影响术中失血量的独立因素。结论患者年龄、BMI、坐骨棘间径、肿瘤距肛缘的距离、腹部手术史、术前放化疗以及合并基础疾病等因素可影响腹腔镜下低位直肠癌手术难度。
Objective To investigate related factors in difficulties of laparoscopic abdominal perineal resection in the treatment of low rectal cancer. Methods Clinical pathological data of 91 patients were retrospectively analyzed,related factors that may affect surgical time,intraoperative blood loss and incidence of postoperative complications were analyzed by single factor analysis and Logistic regression analysis. Results Statistical analysis showed that body mass index（ BMI）（ OR =12. 85,P = 0. 006）,interspinous diameter（ OR = 23. 70,P = 0. 001）,distance of tumor from the anal verge（ OR = 54. 84,P = 0. 032）,history of abdominal surgeries（ OR = 17. 5,P = 0. 029）,preoperative radiochemotherapy（ OR = 21. 25,P = 0. 015）,combination of primary disease（ hypertention and/or diabetes）（ OR = 13. 61,P = 0. 013） were independent factors affecting intraoperative blood loss. Conclusion Patient＇s age,BMI,interspinous diameter,distance of tumor from the anal verge,history of abdominal surgeries,preoperative radiochemotherapy,combination of primary disease can affect the difficulties of laparoscopic low rectal cancer surgery.
作者
汤建军
法镇中
吴杰
张伟元
TANG Jianjun;FA Zhenzhong;WU Jie;ZHANG Weiyuan(Department of General Surgery,Wujin People＇s Hospital in Changzhou City Affiliated to Jiangsu University,Changzhoo,Jiangss,213000)
出处
《实用临床医药杂志》
CAS
2018年第17期50-52,共3页
Journal of Clinical Medicine in Practice
关键词
腹腔镜手术
腹会阴联合切除术
直肠癌
手术难度
影响因素
laparoscopic surgery
abdominal perineal resection
rectal cancer
surgical difficulty
infuencing factors
