结肠癌D3根治术后出现吻合口瘘相关因素多元回归性分析  

Multiple regression analysis of factors associated with anastomotic leakage after D3 lymphadenectomy in patients with colon cancer

作　　者：袁世超[1] 徐丹红[2] YUAN Shichao;XU Danhong(Department of Gastroenterological Surgery,Taizhou Hospital in Zhejiang Province,Taizhou 318000,China;Transfusion Room,Taizhou Hospital in Zhejiang Province,Taizhou 318000,China)

机构地区：[1]浙江省台州市立医院胃肠外科,浙江台州318000 [2]浙江省台州市立医院输液室,浙江台州318000

出　　处：《中国现代医生》2018年第26期19-21,26,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2018KY905)

摘　　要：目的研究分析结肠癌D3根治术后出现吻合口瘘的危险因素,为预防结肠癌D3根治术后吻合口瘘提供可靠的参考依据。方法研究对象选择2015年1月1日～2017年12月31日期间在我院接受结肠癌D3根治术治疗的200例结肠癌患者,对其临床资料进行回顾性研究分析,统计其术后吻合口瘘发生情况,根据术后是否发生吻合口瘘,将患者分为吻合口瘘组、无吻合口瘘组,比较两组临床资料,对导致结肠癌患者D3根治术后吻合口瘘发生的危险因素进行单因素分析、多因素Logistics回归分析。结果经单因素、多因素Logistics回归分析后发现,年龄≥60岁、肿瘤分期为Ⅲ～Ⅳ期、肿瘤位于左半结肠、体重指数≥24 kg/m^2、糖尿病、术前血清白蛋白<35 g/L、手术时间≥150 min是导致结肠癌患者D3根治术后吻合口瘘发生的危险因素。结论结肠癌患者行D3根治术治疗期间,受到年龄、肿瘤TNM分期、肿瘤位置、体重指数、糖尿病、术前血清白蛋白、手术时间等危险因素的影响,其术后易发生吻合口瘘,临床上需针对上述危险因素进行加强干预,以减少术后吻合口瘘的发生。Objective To investigate the risk factors of anastomotic leakage after D3 lymphadenectomy in patients with colon cancer to provide reliable reference for prevention of anastomotic leakage after D3 lymphadenectomy of colon cancer. Methods 200 patients who were with colon cancer and were treated with D3 lymphadenectomy of colon cancer in our hospital from January 1st, 2015 to December 31st, 2017 were selected. Their clinical records were retrospectively analyzed and that if anastomotic leakage occurred was counted. Patients were divided into anastomotic leakage group and non-anastomotic leakage group according to the occurrence of anastomotic leakage. Clinical records of two groups were compared. Univariate analysis and multivariate Logistics regression analysis were used to analyze the risk factors of anastomotic leakage after D3 lymphadenectomy in patients with colon cancer. Results The results of univariate and multivariate Logistics regression analysis showed risk factors of anastomotic leakage after D3 lymphadenectomy in patients with colon cancer were age ≥60 years, tumor stage Ⅲ-Ⅳ, tumor located at left semicolon, body mass index ≥24 kg/m2, diabetes, serum albumin before operation 〈35 g/L and operation duration ≥150 min. Conclusion With the influence of age, tumor TNM staging, tumor location, body mass index, diabetes, serum albumin before operation and operation duration, postoperative anastomotic leakage could easily occur in patients who were with colon cancer and treated with D3 lymphadenectomy. Clinically, strong interventions targeting at the risk factors above should be performed to reduce the incidence of postoperative anastomotic leakage.

关 键 词：结肠癌 吻合口瘘 D3根治术 危险因素 

分 类 号：R656.3[医药卫生—外科学]