腹腔镜直肠癌前切除术后吻合口漏的危险因素分析  

Analysis of Risk Factors for Anastomotic Leakage after Laparoscopic Preresection of Rectal Cancer

作　　者：徐良 汪刘华[3] 张鑫 王刚[2] Xu Liang;Wang Liuhua;Zhang Xin;Wang Gang(Medical School of Yangzhou University,Yangzhou 225003,Jiangsu Province,China;Department of Gastrointestinal Surgery,Lianyungang Second People's Hospital,Lianyungang 222002,Jiangsu Province,China;Department of Gastrointestinal Surgery,Subei People's Hospital Affiliated to the Clinical School of Medicine of Yangzhou University,Yangzhou 225009,Jiangsu Province,China)

机构地区：[1]扬州大学医学院,江苏扬州225003 [2]连云港市第二人民医院胃肠外科,江苏连云港222002 [3]扬州大学临床医学院附属苏北人民医院胃肠外科,江苏扬州225009

出　　处：《中外医药研究》2024年第1期27-29,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析腹腔镜直肠癌前切除术后吻合口漏的危险因素。方法:选取2017年1月—2022年1月于连云港市第二人民医院接受直肠癌前切除术治疗的患者200例为研究对象,根据术后是否出现吻合口漏分为两组,其中未出现吻合口漏的患者作为对照组(11例),出现吻合口漏的患者作为观察组(189例)。收集患者的基本资料[如性别、身体质量指数(BMI)]和疾病相关信息(如肿瘤直径和位置、吻合口处理方式、术后是否出现腹泻),以及手术情况[如是否保留左结肠动脉、吻合口与肛缘的距离等],并进行单因素和多因素Logistic回归分析。结果:单因素分析结果显示,两组性别(男/女)、肿瘤直径、放置经肛直肠减压管、保留左结肠动脉比较,差异无统计学意义(P>0.05);两组BMI、吻合口距离≤5 cm、术后腹泻比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,吻合口距离≤5 cm、术后腹泻是腹腔镜直肠癌前切除术后吻合口漏发生的危险因素(P<0.05)。结论:术后腹泻和吻合口距离≤5 cm是引发腹腔镜直肠癌前切除术后吻合口漏的危险因素,临床可针对危险因素开展积极的预防及管理措施,以期减少这一并发症的发生,提高直肠癌患者的手术安全性和生活质量。Objective:To analyze the risk factors of anastomotic leakage after laparoscopic preresection of rectal cancer.Methods:A total of two hundred patients who received preresection of rectal cancer in Lianyungang Second People's Hospital from January 2017 to January 2022 were selected as the study objects,and were divided into two groups according to whether there was anasto⁃motic leakage after surgery.The patients without anastomotic leakage were used as control group(11 cases),and the patients with anastomotic leakage were used as observation group(189 cases).Basic[gender,body mass index(BMI)]and disease-related infor⁃mation(tumor diameters and location,anastomotic treatment,postoperative diarrhea)were collected,as well as surgical conditions[left colic artery was preserved,distance of anastomosis from anal margin].Univariate and multivariate Logistic regression analysis was performed.Results:Univariate analysis showed that there was no significant difference between the two groups in gender(male/female),tumor diameters,placement of transanal rectal decompression tube and retention of left colic artery(P>0.05);There were significant differences in BMI,anastomotic distance≤5 cm and postoperative diarrhea between the two groups(P<0.05);Mul⁃tivariate Logistic regression analysis showed that the anastomotic distance≤5 cm and postoperative diarrhea were the risk factors for anastomotic leakage after laparoscopic preresection of rectal cancer(P<0.05).Conclusion:Postoperative diarrhea and anasto⁃motic distance≤5 cm are risk factors for anastomotic leakage after laparoscopic preresection of rectal cancer.Active prevention and management measures can be carried out according to risk factors to reduce the occurrence of this complication and improve the surgical safety and quality of life of patients with rectal cancer.

关 键 词：直肠癌前切除术 腹腔镜 吻合口漏 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]