腹腔镜直肠癌Dixon术后吻合口漏的危险因素及防治对策  

Risk factors and prevention of anastomotic leakage after laparoscopic Dixon of rectal cancer

作　　者：秦兴昌 王加一[1] 李海清 Qin Xingchang;Wang Jiayi;Li Haiqing(Department of General Surgery,Anyang People’s Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市人民医院普外科,455000

出　　处：《中国实用医刊》2021年第16期50-53,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨腹腔镜直肠癌低位前切除(Dixon)术后吻合口漏的危险因素及防治对策。方法抽取2016年3月至2020年3月安阳市人民医院腹腔镜直肠癌Dixon术患者208例,调查术后吻合口漏发生情况并分析其防治对策。结果本调查208例腹腔镜直肠癌Dixon术患者中,发生吻合口漏30例,发生率为14.42 %。单因素分析结果显示,不同年龄、体质指数、是否患有糖尿病、术前白蛋白水平、术前是否进行放化疗、临床疾病分期、手术时距肛缘距离、是否放置肛管与术后发生吻合口漏有关(P<0.05);多因素Logistic分析结果显示,年龄>60岁、体质指数>25 kg/m2、患有糖尿病、术前白蛋白水平≤35 g/L、术前放化疗、临床分期Ⅲ期、距肛缘距离≤7 cm、未放置肛管是患者术后吻合口漏的独立危险因素(P<0.05)。结论腹腔镜直肠癌Dixon术后发生吻合口漏的风险与多种因素有关,应重视危险因素的防控,以防治吻合口漏。Objective To discuss the risk factors and prevention of anastomotic leakage after laparoscopic low anterior resection(Dixon)of rectal cancer.Methods A total of 208 cases patients of laparoscopic Dixon for rectal cancer in Anyang People’s Hospital from March 2016 to March 2020 were selected,the occurrence of anastomotic leakage after operation was investigated,and the prevention and treatment measures was analyzed.Results Among the 208 cases of laparoscopic Dixon operation for rectal cancer,30 cases had anastomotic leakage and the incidence was 14.42%.Univariate analysis showed that the age,body mass index,diabetes mellitus,preoperative albumin,preoperative radiotherapy and chemotherapy,clinical stage,distance from anal margin,and placement of anal canal were associated with anastomotic leakage(P<0.05).Logistic analysis showed that,the age>60 years old,body mass index>25 kg/m2,diabetes mellitus,preoperative albumin<35 g/L,preoperative radiotherapy and chemotherapy,clinical stage III,distance from anal margin<7 cm,and absence of anal canal were the independent risk factors for anastomotic leakage(P<0.05).Conclusions There is a risk of anastomotic leakage after laparoscopic Dixon operation for rectal cancer,which is related to many factors.We should pay attention to the prevention and control of risk factors to prevent anastomotic leakage.

关 键 词：腹腔镜 低位前切除术 直肠癌 吻合口漏 

分 类 号：R735.37[医药卫生—肿瘤]