摘要
目的:总结腹腔镜胃癌手术中不良事件发生情况,探讨腹腔镜胃癌手术中不良事件与术后外科并发症之间的关系。方法:回顾分析2017年1月至2020年12月收治的320例腹腔镜胃癌手术患者的手术录像及临床资料,统计术中不良事件发生情况,并对患者的性别、年龄、肿瘤部位、肿瘤大小、病理分化程度、肿瘤分期、淋巴结转移等因素进行分析,研究影响术中不良事件发生的相关因素。统计术后外科并发症情况,分析术中不良事件与术后外科并发症之间的关系。结果:320例患者中23例术中发生不良事件,发生率7.19%,根据N.K.Francis术中不良事件的EAES分级系统进行分级,超过3级的事件为严重术中不良事件,共8例(2.5%,8/320);2级不良事件发生率最高,共12例(3.75%,12/320)。单因素分析显示,年龄、肿瘤最大径、肿瘤T分期、N分期及转移情况、手术时间是影响术中不良事件发生的相关因素(P<0.05),多因素分析采用Logistic回归分析,结果显示,无影响术中不良事件发生的独立因素(P>0.05)。术中不良事件影响术后外科并发症的发生(P<0.05)。结论:腹腔镜胃癌手术中不良事件以2级多见,患者年龄、肿瘤最大径、肿瘤T分期、N分期及转移情况、手术时间是影响术中不良事件发生的相关因素;术中不良事件的发生可增加术后外科并发症发生率。
Objective:To summarize the intraoperative adverse events in laparoscopic gastric cancer surgery and to explore the relationship between intraoperative adverse events and surgical postoperative complications.Methods:The surgical videos and clinical data of 320 patients who underwent laparoscopic gastric cancer surgery from Jan.2017 to Dec.2020 were retrospectively analyzed.The adverse events during laparoscopic gastric cancer surgery was statistically analyzed,and factors such as gender,age,tumor site,tumor size,pathological differentiation degree,tumor stage and lymph node metastasis were analyzed to explore the related factors affecting the occurrence of adverse events during surgery.The postoperative surgical complications were analyzed,and the relationship between intraoperative adverse events and postoperative surgical complications was analyzed.Results:Of the 320 patients,23(7.19%)suffered from intraoperative adverse events.Intraoperative adverse events were classified according to the classification system of EAES for intraoperative adverse events by N.K.Francis.There were 8 cases(2.5%)of serious intraoperative adverse events that exceeded grade 3.Grade 2 adverse events occurred in 12 cases,accounting for 3.75%(12/320).Univariate analysis showed that age,tumor maximum diameter,T stage,N stage,metastasis and operation time were the related factors affecting the occurrence of intraoperative adverse events(P<0.05).Multivariate logistic regression analysis showed that there were no independent factors affecting the occurrence of intraoperative adverse events(P>0.05).Intraoperative adverse events affected the occurrence of postoperative surgical complications(P<0.05).Conclusions:Grade 2 is the most common postoperative adverse event in laparoscopic gastric cancer surgery.Patients'age,tumor maximum diameter,T stage,N stage,metastasis and operation time is related factors to the occurrence of intraoperative adverse events.The occurrence of intraoperative adverse event increases the incidence of postoperative surgi
作者
张大森
张坚
ZHANG Da-sen;ZHANG Jian(Qingdao University,Qingdao 266071,China;Department of General Surgery,Affiliated Hospital of Qingdao University)
出处
《腹腔镜外科杂志》
2022年第5期344-347,共4页
Journal of Laparoscopic Surgery
关键词
胃肿瘤
胃癌根治术
腹腔镜检查
术中不良事件
手术后并发症
Stomach neoplasms
Radical gastrectomy
Laparoscopy
Intraoperative adverse events
Postoperative complications
