腹腔镜右半结肠癌全结肠系膜切除术后胃瘫综合征的影响因素分析  

Risk factors of postsurgical gastroparesis syndrome after complete mesocolic excision for right colon cancer

作　　者：田震 程一帆 李瑞奇 周家杰 赵帅 王伟[2] 汤东[2] 任俊[2] 孙倩男 王道荣 Tian Zhen;Cheng Yifan;Li Ruiqi;Zhou Jiajie;Zhao Shuai;Wang Wei;Tang Dong;Ren Jun;Sun Qiannan;Wang Daorong(Northern Jiangsu People's Hospital,Clinical Teaching Hospital of Medical School,Nanjing University,Yangzhou 225001,China;Department of General Surgery,Northern Jiangsu People's Hospital,Yangzhou 225001,China;Yangzhou Key Laboratory of Basic and Clinical Transformation of Digestive and Metabolic Diseases,Yangzhou 225001,China)

机构地区：[1]南京大学医学院教学医院苏北人民医院,扬州225001 [2]江苏省苏北人民医院胃肠外科,扬州225001 [3]扬州市消化病/代谢病基础与临床转化重点实验室,扬州225001

出　　处：《中华普通外科杂志》2024年第8期584-589,共6页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目(82373014);消化病/代谢病基础与临床转化重点实验室项目(YZ2020159)。

摘　　要：目的探究腹腔镜右半结肠癌全结肠系膜切除术后胃瘫综合征(PGS)的影响因素。方法回顾性分析358例接受腹腔镜右半结肠癌全结肠系膜切除术患者的临床资料。采用单因素及多因素Logistic回归分析PGS的独立危险因素。结果本组358例患者中19例患者(4.8%)发生PGS。Logistic回归分析结果显示,术前焦虑评分(PAS-7)≥14(OR=6.450,P=0.039)、术前血清白蛋白<35 g/L(OR=9.302,P=0.011)、肝曲结肠癌(OR=9.782,P=0.007)、No.206组淋巴结清扫(OR=8.317,P=0.004)及术后腹腔感染(OR=5.755,P=0.043)是PGS发生的独立危险因素。结论腹腔镜右半结肠癌全结肠系膜切除术后胃轻瘫与患者的营养状况、肿瘤位置、淋巴结清扫范围及术后腹腔感染等多种因素有关,应针对性处理。ObjectiveTo investigate the risk factors for postsurgical gastroparesis syndrome(PGS)after laparoscopic complete mesocolic excision(CME)for right colon cancer.MethodsThe clinical data of 358 patients who underwent laparoscopic CME for right colon cancer were retrospectively analyzed.Univariate and multivariate logistics regression were used to analyze the independent risk factors for PGS.ResultsPGS occurred in 19 patients(4.8%).Logistic regression analysis showed that preoperative anxiety score(PAS-7)≥14(OR=6.450,P=0.039),preoperative serum albumin<35 g/L(OR=9.302,P=0.011),colon cancer at hepatic flexura(OR=9.782,P=0.007),No.206 group lymph node dissection(OR=8.317,P=0.004),and intra-abdominal infection(OR=5.755,P=0.043)were independent risk factors for PGS.ConclusionPatient's preoperative health status,tumor location,scope of lymph node dissection and postoperative intra-abdominal infection are all risk factors related to PGS after CME for right colon cancer.

关 键 词：结肠肿瘤 胃肌轻瘫 结肠切除术 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]