腹腔镜辅助胃癌根治术后并发症发生及其影响因素分析  

Analysis of Postoperative Complications and Their Risk Factors after Laparoscopic-Assisted Radical Surgery for Gastric Cancer

作　　者：刘作良[1] 周彤[1] 张广军[1] 

机构地区：[1]川北医学院附属医院胃肠外科肝胆胰肠疾病研究所,四川南充637000

出　　处：《中国普外基础与临床杂志》2015年第9期1107-1111,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨腹腔镜辅助胃癌根治术后并发症的发生情况及其影响因素。方法回顾性分析2010年10月至2013年10月期间于笔者所在医院接受腹腔镜辅助胃癌根治术的300例胃癌患者的临床资料，分析并发症发生情况及其影响因素，同时探讨发生并发症患者和未发生并发症患者的生存差异。结果300例患者中有51例患者发生并发症，并发症发生率为17．0％。单因素分析结果显示：年龄、术前合并疾病情况、美国麻醉师协会（ASA）评级、手术时间及术者手术经验均与腹腔镜辅助胃癌根治术后并发症的发生有关（P〈0．050）。多因素分析结果显示：年龄、术前合并疾病情况和术者手术经验均是腹腔镜辅助胃癌根治术后并发症发生的影响因素（P〈0．050），年龄越大、术前合并疾病及术者手术经验越少者的并发症发生率较高。术后240例患者获访，随访时间3～35个月（中位数为21个月）。并发症组与无并发症组患者的生存曲线比较差异无统计学意义（x^2=0．941，P=0．332）。结论年龄、术前合并疾病情况和术者手术经验是腹腔镜辅助胃癌根治术后并发症发生的影响因素，且发生并发症和未发生并发症患者的生存情况相似。Objective To investigate postoperative complications and their risk factors after laparoscopic-assisted radical surgery for gastric cancer. Methods The clinical data of 300 patients with gastric cancer who underwent [aparoscopic-assisted radical surgery in Affiliated Hospital of North Sichuan Medical College from October 2010 to October 2013 were analTzed retrospectively. Risk factors associated with postoperative complications were assessed by univariate and multivariate analysis, and survival situation of patient with postoperative complications and without postoperative complications was compared by log-rank test. Results Of the 300 patients, postoperative complications occurred in 51 patients （17.0%）. Univariate analysis results showed that, postoperative complication was associate with age, preoperative comorbidity, American Society of Anesthesiologists （ASA） grade, operative time, and experience of surgeon （P〈0.050）. Logistic regression analysis results revealed that, age, preoperative comorbidity, and experience of surgeon were independent risk factors for postoperative complications （P〈0.050）, patients with old age, preoperative comorbidity, and underwent surgery by less experience of surgeon had higher incidence of postoperative complication. Two hundred and forty patients were followed-up for 3-35 months, with the median time of 21 months. There was no significant difference in survival situation between patients with and without postoperative complications （x^2=0.941, P=0.332）. Conclusion Age, preoperative comorbidity, and experience of surgeon are independent risk factors for postoperative complicatons after laparoscopic-assisted radical surgery for gastric cancer, and the survival situationbetween patients with and without postoperative complications is similar.

关 键 词：胃癌 腹腔镜辅助胃癌根治术 并发症 影响因素 预后 

分 类 号：R735.2[医药卫生—肿瘤]