新辅助放疗后直肠癌Miles术后会阴部手术切口难愈的影响因素分析  

Analysis of Factors Leading to Difficult Healing of Perineal Incision After Miles Surgery for Rectal Cancer After Neoadjuvant Radiotherapy

作　　者：张玉姬 马鹏飞 王红丽 王慕蕴 ZHANG Yuji;MA Pengfei;WANG Hongli(Zhengzhou University Affiliated Cancer Hospital,Zhengzhou,450008)

机构地区：[1]郑州大学附属肿瘤医院,450008

出　　处：《实用癌症杂志》2024年第8期1318-1320,1333,共4页The Practical Journal of Cancer

摘　　要：目的探讨影响新辅助放疗后腹会阴联合直肠癌根治术(Miles术)后会阴部手术切口难愈的相关因素。方法回顾性分析125例新辅助放疗后直肠癌Miles术患者的临床资料,统计其术后会阴部手术切口愈合情况,并经单因素及多因素分析影响患者术后会阴部手术切口难愈的相关因素。结果125例新辅助放疗后直肠癌Miles术患者中,有34例患者术后会阴部手术切口难愈,会阴部手术切口难愈率为27.20%(34/125)。单因素分析显示,性别、年龄、有无合并高血压、体质量指数、腹壁切口直径、盆底腹膜修复、术前白蛋白与患者术后会阴部手术切口难愈无关(P>0.05);有无合并糖尿病、放疗后与手术间隔时间、伤口腔内积液是否完全引流与患者术后会阴部手术切口难愈有关(P<0.05);Logistic回归分析显示:合并糖尿病、放疗后间隔1周手术、伤口腔内积液未完全引流是患者术后会阴部手术切口难愈的重要因素(P<0.05)。结论合并糖尿病、放疗后手术间隔时间、伤口腔内积液是否完全引流是影响新辅助放疗后直肠癌Miles术后会阴部手术切口难愈的相关因素,临床需重视并采取相关措施促使术后会阴部手术切口愈合。Objective To explore the related factors that affect the difficulty of healing the perineal surgical incision after neoadjuvant radiotherapy combined with radical resection of rectal cancer(Miles surgery).Methods A retrospective analysis was conducted on the clinical data of 125 patients with rectal cancer underwent Miles surgery after neoadjuvant radiotherapy.The healing status of postoperative perineal surgical incisions was statistically analyzed,and the relevant factors affecting the difficulty of postoperative perineal surgical incisions were analyzed through single factor and multiple factor analysis.Results Among the 125 patients who underwent Miles surgery for rectal cancer after neoadjuvant radiotherapy,34 patients had a difficult to heal perineal surgical incision,with a difficult to heal rate of 27.20%(34/125);Univariate analysis showed that gender,age,presence or absence of concomitant hypertension,body mass index,abdominal wall incision diameter,pelvic floor peritoneal repair,preoperative albumin were not associated with postoperative difficulty in healing of perineal surgical incisions in patients(P>0.05);The presence or absence of diabetes,the interval between operations after radiotherapy,and the complete drainage of fluid in the injured mouth were related to the difficulty of perineal incision healing(P<0.05);Logistic regression analysis showed that the complications of diabetes,the operation interval of 1 week after radiotherapy,and the incomplete drainage of the fluid in the injured mouth were the important factors for the difficulty in healing the perineal incision after surgery(P<0.05).Conclusion The presence or absence of diabetes,the interval between operations after radiotherapy,and whether the fluid accumulated in the injured mouth is completely drained are related factors that affect the perineal incision healing after Miles operation for rectal cancer after neoadjuvant radiotherapy.Clinical attention should be paid to these factors,and relevant measures should be taken to promote the pe

关 键 词：直肠癌 新辅助放疗 腹会阴联合直肠癌根治术 切口难愈 影响因素 

分 类 号：R735.37[医药卫生—肿瘤]