腹腔镜胃癌根治术中血管损伤的高危因素研究  

Study on High Risk Factors of Vascular Injury During Laparoscopic Radical Gastrectomy

作　　者：项霙 憨春红[1] 樊梦琪 高晓庆 田静静[1] XIANG Xiang;HAN Chunhong;FAN Mengqi(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第7期1181-1183,共3页The Practical Journal of Cancer

摘　　要：目的研究腹腔镜胃癌根治术中血管损伤的高危因素。方法回顾性分析97例胃癌患者临床资料。统计患者基本情况、病理资料及术者手术经验等资料。依据术中是否出现血管损伤分为未损伤组、损伤组。统计术中血管损伤发生情况,采用Logistic回归分析对术中血管损伤的独立危险因素进行研究。结果97例患者中有22例患者发生术中血管损伤,血管损伤发生率为23.40%(22/94);损伤组年龄≥60岁(72.73%)、N分期N2+N3期(77.27%)、肿瘤大小≥3.5 cm患者比率(59.09%)均高于未损伤组(40.00%、49.33%、26.67%),差异有统计学意义(P<0.05);两组在性别、BMI、腹部手术史、病理分期、T分期、肿瘤位置及术者手术经验方面对比,差异无统计学意义(P>0.05);Logistic回归分析显示,年龄、N分期、肿瘤大小为影响术中血管损伤的独立危险因素(P<0.05且OR≥1)。结论腹腔镜胃癌根治术中血管损伤发生率较高,影响术中血管损伤的独立危险因素主要包括年龄、N分期、肿瘤大小,需要加强对存在上述危险因素患者的术前评估,以减少术中血管损伤发生率。Objective To study the high risk factors of vascular injury during laparoscopic radical gastrectomy.Methods The clinical data of 97 patients with gastric cancer were analyzed retrospectively.The basic information of patients,pathological data and surgical experience of operators were collected.They were divided into non-injured group and injured group according to whether there was vascular injury during operation.The incidence of intraoperative vascular injury was counted,and the independent risk factors of intraoperative vascular injury were studied by logistic regression analysis.Results Among the 97 patients,22 patients had intraoperative vascular injury,and the incidence of vascular injury was 23.40%(22/94);The rate of patients with age≥60 years(72.73%),N stage N2+N3 stage(77.27%),and tumor size≥3.5 cm(59.09%)in the injured group were higher than those in the non-injured group(40.00%,49.33%,26.67%),and the difference was statistically significant(P<0.05);There was no significant difference between the 2 groups in gender,BMI,abdominal surgery history,pathological stage,T stage,tumor location and surgical experience(P>0.05);Logistic regression analysis showed that age,N stage and tumor size were independent risk factors for vascular injury during operation(P<0.05 and OR≥1).Conclusion The incidence of vascular injury during laparoscopic radical resection of gastric cancer is high.The independent risk factors affecting vascular injury during operation mainly include age,N stage and tumor size.It is necessary to strengthen the preoperative evaluation of patients with these risk factors to reduce the incidence of vascular injury during operation.

关 键 词：胃癌 腹腔镜胃癌根治术 血管损伤 高危因素 

分 类 号：R735.2[医药卫生—肿瘤]