直肠癌保肛手术预防性造瘘的指征分析  

Indication analysis for defunctioning stoma following sphincter preserving surgery

作　　者：韩亚东[1] 朱孝成[2] 李向农[2] 李超[2] 杨军[2] 时林森[2] 王辉[2] 孟松[2] 

机构地区：[1]徐州医学院研究生学院普外科,江苏徐州221004 [2]徐州医学院附属医院普外科,江苏徐州221006

出　　处：《中国肿瘤外科杂志》2015年第2期69-73,共5页Chinese Journal of Surgical Oncology

摘　　要：目的研究直肠癌保肛手术后发生吻合口漏的原因,探索预防性造瘘的指征。方法以徐州医学院附属医院2004年3月至2014年3月收治的816例直肠癌保肛手术患者作为研究对象,收集其年龄、性别、基础疾病、营养状态、吸烟史、酗酒史,结合术中出血量、手术时间、吻合口高度等资料,观察以上因素与术后吻合口漏的关系,并进行统计学分析。结果男性、年龄≥65岁、糖尿病、酗酒、吻合口高度≤5cm、手术时间>3小时的患者术后出现吻合口漏的概率较其相应对照组高,差异有统计学意义。结论性别、年龄、糖尿病、酗酒、低位吻合及手术时间等指标作为直肠癌保肛手术后吻合口漏的危险因素,对于评估术中行预防性造瘘的必要性有重要临床意义。Objective To investigate the reasons of anastomotic leakage （ AL ） after sphincter preserving surgery of rectal cancer, and find the indications for defunctioning stoma. Methods 816 rectal cancer patients who underwent sphincter preserving surgery in our hospital from Mar. 2004 to Mar. 2014 were treated as research subjects. Factors such as their age, gender, underlying diseases, nutritional status, smoking history and alcohol abuse, blood loss, operative time, anatomotic height were collected for researching. The relationship between AL and the collecting factors were statistically analyzed. Results The rates of AL of male, aged ≥65 years, diabetes, alcoholism, anastomosis height≤5cm, the length of surgery more than three hours, are significantly higher than their corresponding control group. Conclusions Gender, age, diabetes, alcoholism, low anastomosis and surgical time can be treated as risk factors for AL following sphincter preserving surgery, and these factors might play important roles in evaluating the necessity of defunctioning stoma.

关 键 词：直肠癌 保肛手术 吻合口漏 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]