腹腔镜下结肠癌根治术后吻合漏发生的危险因素分析  

Risk factors for anastomotic leakage following laparoscopic resection for colon cancer

作　　者：梁万强[1,2] 樊彩凤 高军平[1,2] 

机构地区：[1]广西医科大学第三附属医院 [2]南宁市第二人民医院普通外科,南宁市530031

出　　处：《广西医学》2015年第3期347-349,共3页Guangxi Medical Journal

摘　　要：目的探讨腹腔镜下结肠癌根治术后吻合漏发生的相关危险因素。方法 162例行腹腔镜下结肠癌根治术结肠癌患者,术后发生吻合漏16例(吻合漏组),未发生吻合漏146例(无吻合漏组),对患者术后发生吻合漏的相关因素进行分析。结果单因素分析显示:合并糖尿病、合并贫血、手术时间大于270 min、BMI大于25 kg/m2、有腹腔感染、吻合距肛缘距离大于5 cm与吻合漏发生有关(P均<0.05);而性别、年龄、手术方式、肿瘤浸润深度与吻合漏发生无关(P均>0.05)。logistic回归分析结果:合并糖尿病、手术时间是大于270 min、BMI大于25 kg/m2、腹腔感染、吻合距肛缘距离<5 cm是吻合漏发生的危险因素(P<0.05)。结论合并糖尿病、手术时间是大于270 min、BMI大于25 kg/m2、腹腔感染、吻合距肛缘距离是<5 cm是腹腔镜下结肠癌根治术后吻合漏发生的危险因素,因尽量避免并及时采取相应的预防措施。Objective To explore the related risk factors for anastomotic leakage after laparoscopic resection for colon cancer. Methods One hundred and sixty-two colon cancer patients underwent laparoscopic colonic resection, including 16 with postoperative anastomotie leakage（ anastomotie leakage group） and 146 without anastomotic leakage （non-anastomotic leakage group）. The analysis on the related factors of postoperative anastomotic leakage was performed. Results Univariate analysis showed that diabetes mellitus, anemia, operation duration more than 270 minutes, body mass index （BMI） greater than 25 kg/m^2, abdominal infection, distance from anastomosis to anal margin more than 5 cm were related with the incidence of anastomotic leakage （all P 〈 0. 05 ） , but gender, age, operation mode and depth of tumor invasion weren＇t related with the incidence of anastomosis leakage（ all P 〉 0.05 ）. The results of logistic regression analysis showed that diabetes mellitus, operation duration more than 270 minutes, BMI greater than 25 kg/m^2 , abdominal infection and distance from anastomosis to anal margin less than 5 cm were the risk factors for anastomosis leakage （P 〈 0.05 ）. Conclusion Diabetes mellitus, operation duration more than 270 minutes, BMI greater than 25 kg/m^2, abdominal infection and distance from anastomosis to anal margin less than 5 cm are the risk factors for anastomotic leakage occurs after laparoscopic resection for colon cancer. The corresponding prevention measures should be taken in time.

关 键 词：结肠癌 腹腔镜 根治术 吻合漏 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]