腹腔镜下直肠癌低位前切除术后重度LARS的危险因素分析  

Analysis of Risk Factors for Severe Low Anterior Resection Syndrome After Low Anterior Resection for Rectal Cancer

作　　者：陈超 郑鑫[1] 熊兵 崔铭堃 马福源 丁佩剑[1] CHEN Chao;ZHENG Xin;XIONG Bing(The Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院胃肠外科,承德河北067000

出　　处：《河北医学》2024年第6期936-941,共6页Hebei Medicine

基　　金：河北省省级科技计划资助,(编号:203777101D)。

摘　　要：目的:探讨行低位直肠前切除术的直肠癌患者出现重度低位前切除综合征(LARS)的危险因素。方法:选取2019年2月至2021年5月于承德医学院附属医院行直肠癌低位前切除术的156例患者作为研究对象。通过电话随访、门诊随访等方式对患者进行术后评估,计算LARS量表得分。采用单因素分析和多因素Logistic回归分析探究发生重度LARS的影响因素。结果:156例患者中,术后69例(44.23%)发生LARS,其中轻度LARS 34例(21.79%),重度LARS 35例(22.44%)。单因素分析结果表明,肥胖、术前实施新辅助放疗、吻合口距齿线高度≤2cm、术后并发吻合口漏与重度LARS发生具有关联性(P<0.05)。多因素回归分析结果显示,术前实施新辅助放疗、吻合口距齿线高度≤2cm、BMI≥25kg/m^(2)以及术后患者发生吻合口漏与重度LARS密切相关。结论:低位直肠癌患者术后存在较高LARS发生率,肥胖、新辅助放疗、吻合口距离≤2cm、术后并发吻合口漏是重度LARS发生的独立危险因素。Objective:To investigate the hazard factors for severe low anterior resection syndrome(LARS)in patients with rectal cancer after low anterior resection.Methods:A total of 156 patients who underwent low anterior resection for rectal cancer at the Affiliated Hospital of Chengde Medical College from February 2019 to May 2021 were selected as the study subjects.The patients were evaluated postoperatively by telephone follow-up and outpatient visits,and the LARS score was calculated.Univariate and multivariate logistic regression analyses were used to explore the factors influencing the occurrence of severe LARS.Results:Among the 156 patients,69 cases(44.23%)developed LARS,including 34 cases of mild LARS(21.79%)and 35 cases of severe LARS(22.44%).Univariate analysis indicated that neoadjuvant radiotherapy,obesity,height of anastomosis to tooth line(≤2cm),and stomal leak after operation were closely related to severe LARS.Multivariate regression analysis showed that preoperative neoadjuvant radiotherapy,anastomosis-to-dentate line height less than 2cm,BMI≥25kg/m^(2),and postoperative anastomotic leakage were closely related to the occurrence of severe LARS.Conclusion:Patients with low anterior resection have a higher risk of LARS.Obesity,neoadjuvant radiotherapy,anastomosis distance less than 2cm,and postoperative anastomotic leakage are independent risk factors for severe LARS.

关 键 词：直肠癌 重度低位前切除综合征 危险因素 

分 类 号：R735.37[医药卫生—肿瘤]