腹腔镜直肠癌根治术后并发症及其相关因素分析  

Factors associated with complication after laparoscopic-assisted radical rectal surgery for rectal cancer

作　　者：刘林[1] 王海江[1] 赵泽亮[1] 杨新辉[1] 王琦三[1] 赵为民[1] 雷程[1] 金博[1] 

机构地区：[1]新疆医科大学附属肿瘤医院胃肠外科,新疆乌鲁木齐830011

出　　处：《中国实用外科杂志》2013年第8期683-686,共4页Chinese Journal of Practical Surgery

摘　　要：目的分析腹腔镜直肠癌根治术后并发症发生率及其相关因素。方法回顾性分析新疆医科大学附属肿瘤医院2008年4月至2012年4月间施行腹腔镜直肠癌根治术的305例病人的临床资料，观察术后并发症发生情况，分析并发症组与无并发症组临床资料的差异。对发生术后并发症的危险因素进行多因素Logisitic回归分析。结果305例病人出现并发症76例（24．9％）；单因素分析显示：病人的性别、发病年龄、术前合并症、肿瘤位置、TNM分期、新辅助治疗、术者手术经验及手术时间与腹腔镜直肠根治术后并发症相关（P〈0．05）。多因素回归分析显示：性别、术前合并症、肿瘤位置、TNM分期和术者手术经验是影响术后并发症发生的独立危险因素。275例（90．2％）病人获得2～48（中位数24）个月的随访，并发症组与无并发症组的复发率和生存曲线差异均无统计学意义（P〉0．05）。结论影响腹腔镜直肠癌根治术并发症发生的独立危险因素为性别、术前合并症、肿瘤位置、TNM分期和术者手术经验。Objective To investigate factors associated with postoperative complications after laparoscopic-assisted radical rectal surgery in rectal cancer. Methods The clinical data of 305 patients with rectal cancer performed laparoscopic-assisted radical resection from April 2008 to April 2012 in Affiliated Tumor Hospital of Xinjiang Medical University were analyzed retrospectively. All the data were analyzed by the t test, ehi-square test, Fisher exact probability or Logistic regression model. Results Postoperative complication occurred in 76 patients （24.9%）. On univariate analysis, postoperative complication was associate with gender, age, preoperative comorbidity, location of tumor, TNM staging, neoadjuvant chemoradiotherapy, operative time and surgeon experience （P〈O.05）. Logistic regression analysis revealed that gender, preoperative comorbidity, location of tumor, TNM staging and surgeon experience were independent risk factors for postoperative complications （P 〈 0.05）. Follow up was available in 275 patients （90.2%） with a median follow up of 24 months （rang, 2-48months）. Differences in survival and recurrence rate between patients with and without postoperative complication were of no statistical significance （P 〉0.05）. Conclusion Gender, preoperative comorbidity, location of tumor, TNM staging, surgeon experience were independent risk factors for postoperative complications in laparoscopic-assisted radical rectal surgery in rectal cancer.

关 键 词：腹腔镜 直肠癌 并发症 

分 类 号：R6[医药卫生—外科学]