直肠癌腹会阴联合切除术后造口旁疝发生的危险因素分析  

Risk factor of parastomal hernia after abdominoperineal excision for rectal cancer

作　　者：沈荐[1] 李敏哲[1] SHEN Jian;LI Minzhe(Department of General Surgery,Beijing Chao-Yang Hospital Affiliated to Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院普外科,北京100020

出　　处：《现代肿瘤医学》2023年第4期690-693,共4页Journal of Modern Oncology

摘　　要：目的:探讨直肠癌腹会阴联合切除(APR)术后造口旁疝发生的影响因素。方法:回顾性分析2008年1月-2018年12月于我院普外科行APR的163例低位直肠癌患者的临床资料。随访术后造口旁疝的发生情况,对可能影响造口旁疝发生的因素进行单因素分析和多因素Logistic回归分析。结果:163例行APR的直肠癌患者,术后有29例出现造口旁疝,造口旁疝的发生率为17.79%;其中Ⅰ型19例(65.52%),Ⅱ型4例(13.79%),Ⅲ型4例(13.79%),Ⅳ型2例(6.90%)。造口旁疝发生的时间为术后5~30个月,中位时间18个月。单因素分析显示,年龄≥65岁、BMI≥28 kg/m^(2)、经腹腔途径造口、手术时间>4 h与APR术后造口旁疝的发生相关(P<0.05)。多因素Logistic回归分析显示,BMI≥28 kg/m^(2)是APR术后造口旁疝发生的独立危险因素(OR=4.202,P<0.05)。结论:BMI≥28 kg/m^(2)是APR术后造口旁疝发生的独立危险因素。针对肥胖的低位直肠癌患者,应采取合理的预防及治疗措施,以期减少APR术后造口旁疝的发生。Objective:To analyze the risk factors of parastomal hernia after abdominoperineal resection(APR)for rectal cancer.Methods:The clinical data of 163 patients with low rectal cancer who underwent APR in the department of general surgery of our hospital from January 2008 to December 2018 were retrospectively analyzed.The incidence of parastomal hernia was followed up,and the possible factors influencing the occurrence of parastomal hernia were analyzed by univariate analysis and multivariate Logistic regression analysis.Results:The incidence of parastomal hernia after APR was 17.79%.There were 19 cases of type I(65.52%),4 cases of type Ⅱ(13.79%),4 cases of type Ⅲ(13.79%)and 2 cases of type Ⅳ(6.90%).The median time of parastomal hernia was 18 months(range,5~30 months).Univariate analysis showed that age≥65 years,BMI≥28 kg/m^(2),transabdominal stoma,operation time>4 h were associated with the occurrence of parastomal hernia after APR(P<0.05).Multivariate logistic regression analysis showed that BMI≥28 kg/m^(2)was an independent risk factor for parastomal hernia after APR(OR=4.202,P<0.05).Conclusion:BMI≥28 kg/m^(2)is an independent risk factor for the occurrence of parastomal hernia after APR.For obese patients with low rectal cancer,reasonable prevention and treatment measures should be taken to reduce the incidence of parastomal hernia after APR.

关 键 词：造口旁疝 直肠肿瘤 腹会阴联合切除术 多因素分析 肥胖 

分 类 号：R735.3[医药卫生—肿瘤]