摘要
目的 探讨腹腔镜辅助胃癌根治术后并发症的Clavien-Dindo分级情况及影响因素。方法 2014年1月~2019年6月间行腹腔镜辅助胃癌根治术病人478例,根据Clavien-Dindo分级系统分析术后并发症的发生情况,采用Logistic回归分析术后并发症发生的影响因素。结果 478例病人出现术后并发症84例(17.6%),并发症Clavien-Dindo分级Ⅰ级6例,Ⅱ级59例,Ⅲa级11例,Ⅲb级4例,Ⅳa级3例,Ⅴ级1例。Logistic单因素分析结果显示,病人年龄、体质指数(BMI)、术前合并症、手术时间、术中出血量、肿瘤直径、围手术期输血与术后并发症发生有关(P<0.05)。多因素分析表明,年龄≥65岁(OR=2.251,P=0.002)、BMI≥28 kg/m^(2)(OR=2.970,P=0.019)、手术时间>180分钟(OR=1.771,P=0.035)、术中出血量≥200 ml(OR=1.825,P=0.045)和围手术期输血(OR=1.990,P=0.045)是腹腔镜辅助胃癌根治术后并发症发生的独立危险因素(P<0.05)。年龄、BMI、手术时间、术中出血量及围手术期输血的并发症Clavien-Dindo分级结果差异均有统计学意义(P<0.05)。结论 腹腔镜辅助胃癌根治术后并发症应用Clavien-Dindo分级可对手术的安全性进行评估,常见并发症为Clavien-Dindo分级Ⅱ级,病人年龄、BMI、手术时间、术中出血量及围手术期输血是术后并发症发生独立危险因素。
Objective To investigate the Clavien-Dindo classification of complications after laparoscopic-assisted radical gastrectomy and the impact factors.Methods Clinical data of 478 patients with gastric cancer undergoing laparoscopic-assisted radical resection from January 2014 to June 2019 were analyzed retrospectively.The postoperative complications were assessed by Clavien-Dindo classification, and the impact factors associated with postoperative complications were assessed by using the Logistic regression model.Results Of the 478 patients, postoperative complications occurred in 84 patients(17.6%).The Clavien-Dindo classification of postoperative complication: 6 patients were detected in gradeⅠ,59 in gradeⅡ,11 in grade Ⅲa, 4 in grade Ⅲb, 3 in grade Ⅳa and 1 in grade Ⅴ,respectively.On univariate logistic analysis, postoperative complication was associated with age, BMI,preoperative comorbidity, surgical duration, intraoperative blood loss, tumor size and perioperative transfusion.Multivariate analysis revealed that age age≥65 years, BMI≥28 kg/m^(2),surgical duration time>180 min, intraoperative blood loss≥200 ml and perioperative transfusion were independent risk factors for postoperative complications.The grades of Clavien-Dindo classification were significantly different between patients with different age, BMI,surgical duration, intraoperative blood loss and perioperative transfusion(all P<0.05).Conclusion Clavien-Dindo classification of complicationsis beneficial to the comprehensive evaluation of safety of laparoscopic-assisted radical gastrectomy.The mainly complications after laparoscopic-assisted radical gastrectomy are grade Ⅱ of Clavien-Dindo classifification.Age, BMI,surgical duration, intraoperative blood loss and perioperative transfusion were independent risk factors for postoperative complications in laparoscopic-assisted radical gastrectomy.
作者
陈建新
林铭
金文海
CHEN Jianxin;LIN Ming;JIN Wenhai(Department of Gastrointestinal Surgery,Affiliated Hospital of Putian University,Fujian,Putian 351100,China)
出处
《临床外科杂志》
2022年第2期171-174,共4页
Journal of Clinical Surgery
关键词
胃肿瘤
腹腔镜
Clavien-Dindo分级
并发症
stomach neoplasms
laparoscopic surgical procedures
Clavien-Dindo classification
postoperative complication
