低位直肠癌前切除术后吻合口漏的相关危险因素分析  

Analysis on related risk factors of anastomotic leakage after low rectal cancer resection operation

作　　者：李明[1] 寇卫军[1] 寇明文[1] 张文博[1] 

机构地区：[1]解放军第155中心医院普通外科,河南开封475003

出　　处：《重庆医学》2017年第36期5123-5125,共3页Chongqing medicine

摘　　要：目的探讨低位直肠癌前切除术后吻合口漏的相关危险因素。方法回顾性分析2011年1月至2016年6月在该院行低位直肠癌前切除术的158例患者的临床资料,对患者临床特征及治疗因素行单变量和多变量的相关性分析。结果吻合口漏的总发病率为5.7%(9/158)。单因素分析显示患者年龄、性别、BMI、术前合并疾病、肿瘤分期、部位、病理类型、术前有无肠梗阻、手术方式(腹腔镜与开腹手术)与术后吻合口漏发生率无显著相关性(P>0.05)。预防性回肠造口术不影响吻合口漏的发生率(P=0.694)。术后放置经肛直肠减压管可降低吻合口漏的发生率(P=0.047)。单变量及多变量分析显示术后腹泻是吻合口漏发生的独立危险因素(OR=10.522,P=0.001)。结论术后早期腹泻是低位直肠癌前切除术后吻合口漏发生的独立危险因素。术后放置经肛直肠减压管可降低吻合口漏的发生率。Objective To explore the related risk factors of anastomotic leakage after low rectal cancer anterior resection operation.Methods The clinical data of 158 patients with low rectal cancer anterior resection operation in this hospital from January2011 to June 2016 were retrospectively analyzed.The clinical features and treatment factors were performed the univariate and multivariate correlation analysis.Results The total incidence rate of anastomotic leakage was 5.7%（9/158）.The univariate analysis showed that the age,sex,body mass index（BMI）,preoperative concurrent disease,tumor stage,location,pathological type,preoperative intestinal obstruction and surgical mode（laparoscopy and laparotomy）had no significant correlation with postoperative anastomotic leakage（P〉0.05）.Preventive ileostomy did not affect the incidence rate of anastomotic leakage（P=0.694）.Postoperative placement of anorectal decompression tube could reduce the incidence rate of anastomotic leakage（P=0.047）.The univariate and multivariate analysis showed that postoperative diarrhea was an independent risk factor for anastomotic leakage occurrence（OR=10.522,P=0.001）.Conclusion Postoperative early diarrhea is an independent risk factor for anastomotic leakage occurrence after rectal cancer anterior resection operation.Postoperative placement of anorectal decompression tube can reduce the incidence rate of anastomotic leakage.

关 键 词：直肠肿瘤 外科吻合口 腹泻 经肛直肠减压 

分 类 号：R735.37[医药卫生—肿瘤]