摘要
目的:探讨远端胃癌患者行微创手术后并发症发生的相关因素。方法:回顾性分析选取2015年1月—2018年1月河南大学第一附属医院收治的138例远端胃癌患者,均行腹腔镜辅助胃癌根治术治疗。138例患者中28例出现术后并发症,作为并发症组,其余110例患者为对照组。分析并发症发生情况,单因素和Logistic多因素分析远端胃癌患者行微创手术后并发症发生的相关因素。结果:28例(20.28%)患者出现术后并发症,主要为胃排空障碍、吻合口瘘、肠梗阻和不明原因发热。单因素分析结果显示,术前伴发疾病、肿瘤T分期、分化程度、组织分型、术前营养、消化道重建方式及施术者经验与远端胃癌患者行微创手术后并发症发生有关(P<0.05)。Logistic多因素分析结果显示,术前伴发疾病、低/中分化程度、腺癌、无术前营养、消化道重建方式为BillrothⅡ式吻合术、施术者经验≤5年是远端胃癌患者行微创手术后并发症发生的危险因素(P<0.05)。结论:远端胃癌患者行微创手术后多发胃排空障碍、吻合口瘘、肠梗阻和不明原因发热等并发症,应对术前伴发疾病、低/中分化程度、腺癌、消化道重建方式为BillrothⅡ式吻合术的远端胃癌患者加强监控,积极改善术前机体状况,提高免疫力,选择适当的手术方式,以降低术后并发症发生率。
Objective： To explore the related factors of complications after minimally invasive surgery in patients with distal gastric cancer. Methods： The clinical data of 138 patients with distalb gastric cancer treated in our hospital between January 2015 and January 2018 were retrospectively analyzed. All patients underwent laparoscopic radical gastrectomy for gastric cancer. Of the 138 patients, 28 patients had postoperative complications in the complication group and the remaining 110 patients in the control group. Analysis of complications, univariate and Logistic multivariate analysis of factors related to the incidence of complications after minimally invasive surgery in patients with distal gastric cancer. Results： Postoperative complications occurred in 28 patients （20.28%）, mainly gastric emptying, anastomotic leakage, intestinal obstruction and unexplained fever. Univariate analysis showed that preoperative associated disease, tumor T stage, differentiation, tissue typing, preoperative nutrition, digestive tract reconstruction and experience of the surgeon were closely related to the occurrence of complication after minimally invasive surgery in patients with distal gastric cancer（P〈0.05）. Logistic multivariate analysis showed that preoperative concomitant disease, low/medium differentiated tumor, adenocarcinoma, no preoperative nutrition, digestive tract reconstruction was Billroth II anastomosis, and the experience of the surgeon was ≤5 years. Were risk factors for the incidence of complications after minimally invasive surgery（P〈0.05）. Conclusion： Patients with distal gastric cancer undergo multiple minimally invasive surgery, such as gastric emptying disorder, anastomotic leakage, intestinal obstruction and unexplained fever. Respiratory monitoring of preoperative pre-existing disease, low/medium differentiated tumor, adenocarcinoma, and digestive tract reconstruction in patients with distal gastric cancer undergoing Billroth II anastomosis, positively improve preoperative body con
作者
邢燕来
王晓磊
XING Yan-lai;WANG Xiao-lei(Department of General Surgery,The First Affiliated Hospital of Henan University（Kaifeng 475000,China)
出处
《中国现代普通外科进展》
CAS
2018年第11期860-863,867,共5页
Chinese Journal of Current Advances in General Surgery
基金
河南省教育厅科学技术研究重点项目(18A320020)
关键词
远端胃癌
腹腔镜辅助胃癌根治术
并发症
相关因素
Distal gastric cancer；Laparoscopic radical gastrectomy；Complications；Related factors
