腹腔镜结直肠癌术后非计划再次手术原因及危险因素分析  

Analysis of causes and risk factors of unplanned reoperation after laparoscopic colorectal cancer surgery

作　　者：韦小波[1] 劳景茂[1] WEI Xiaobo;LAO Jingmao(Department of Gastrointestinal Surgery,Qinzhou Municipal First People's Hospital,Qinzhou,Guangxi 535000,China)

机构地区：[1]钦州市第一人民医院胃肠外科,广西钦州535000

出　　处：《现代医药卫生》2024年第1期56-59,共4页Journal of Modern Medicine & Health

基　　金：广西壮族自治区临床重点专科建设项目(桂卫医发[2022]17号);钦州市科学研究与技术开发科技攻关课题(20202725)。

摘　　要：目的探讨腹腔镜结直肠癌手术后非计划再次手术原因及相关危险因素。方法回顾性分析2015年1月至2022年12月该院胃肠外科腹腔镜下结直肠癌手术1641例患者的临床资料,术后发生非计划再次手术15例,分析其非计划再次手术的原因,并且单因素和多因素logistic回归分析其危险因素。结果腹腔镜结直肠癌术后非计划再次手术发生率为0.91%,主要原因是吻合口瘘(26.67%)、肠梗阻(20.00%);通过对症治疗,12例治愈,2例主动出院,1例死亡。单因素和多因素回归分析显示,术前糖尿病、术前低蛋白血症、术中出血量多和腹部手术史为非计划再次手术的独立危险因素(P<0.05)。结论腹腔镜下结直肠癌术后非计划再次手术发生最常见的原因为吻合口瘘和肠梗阻,对合并糖尿病、低蛋白血症、术中出血量多的患者应注意加强防范该疾病的发生。Objective To explore the causes and related risk factors of unplanned reoperation after laparoscopic colorectal cancer surgery.Methods The clinical data of 1 641 patients undergoing laparoscopic colorectal cancer surgery in the gastrointestinal surgery department of this hospital from January 2020 to December 2022 were retrospectively analyzed.Fifteen patients underwent the unplanned reoperation after surgery.The causes of unplanned reoperation were analyzed,and the risk factors were analyzed by the univariate and multivariate logistic regression.Results The incidence rate of unplanned reoperation after laparoscopic surgery for colorectal cancer was 0.91%.The main causes were the anastomotic fistula(26.67%) and intestinal obstruction(20.00%);through symptomatic treatment,12 cases were cured,2 cases were discharged automatically and 1 case died.The univariate and multivariate regression analysis showed that preoperative diabetes,preoperative hypoproteinemia,excessive intraoperative bleeding and history of abdominal surgery were the independent risk factors for unplanned reoperation(P<0.05).Conclusion The most common causes of unplanned reoperation after laparoscopic colorectal cancer surgery are the anastomotic leakage and intestinal obstruction.For the patients with diabetes,hypoproteinemia and excessive intraoperative bleeding,the attention should be paid to the prevention of this disease.

关 键 词：腹腔镜 结直肠癌 非计划再次手术 原因 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]