低位结直肠癌患者经括约肌间切除术后吻合口狭窄的影响因素分析  

Analysis of Influencing Factors of Anastomotic Stenosis in Patients with Low Colorectal Cancer After Intersphincteric Resection

作　　者：李进瑾 李丹 郜时莉 LI Jinjin;LI Dan;GAO Shili(Xinxiang Central Hospital,Xinxiang,453000)

机构地区：[1]河南省新乡市中心医院,453000 [2]河南省新乡龙华医院,453700

出　　处：《实用癌症杂志》2024年第10期1714-1717,共4页The Practical Journal of Cancer

摘　　要：目的探讨低位结直肠癌患者经括约肌间切除术(ISR)后吻合口狭窄的影响因素。方法选取80例接受ISR术治疗的低位结直肠癌患者,根据术后是否发生吻合口狭窄分为狭窄组(n=15)、未狭窄组(n=65),探究导致吻合口狭窄发生的危险因素。结果单因素分析结果显示,2组在性别、肿瘤下缘距肛缘距离、术前新辅助放疗、炎症性肠病、糖尿病、术后吻合口瘘方面差异显著(P<0.05),而在年龄、体质量指数、高血压、术前血红蛋白、白蛋白、总蛋白、TNM分期、肿瘤最大径、肿瘤分化程度、ISR术式、手术时间、术中出血量、肠系膜下动脉离断水平、吻合口高度等方面差异无统计学意义(P>0.05);多因素分析提示,男性、术前新辅助放疗、炎症性肠病、糖尿病、术后吻合口瘘是导致吻合口狭窄的独立危险因素(P<0.05)。结论男性、术前新辅助放疗、炎症性肠病、糖尿病、术后吻合口瘘可能诱发低位结直肠癌患者ISR术后吻合口狭窄,应采取相应干预措施,以降低吻合口狭窄发生率。Objective To investigate the factors affecting anastomotic stenosis after intersphincteric resection(ISR)in patients with low colorectal cancer.Methods A total of 80 patients with low colorectal cancer treated by ISR were selected and divided into a narrow group(n=15)and a non-narrow group(n=65)according to whether anastomotic stenosis occurred after surgery,and the risk factors for the occurrence of anastomotic stenosis were investigated.Results Univariate analysis showed significant differences between the 2 groups in terms of gender,distance from lower tumor margin to anal margin,preoperative neoadjuvant radiotherapy,inflammatory bowel disease,diabetes mellitus,and postoperative anastomotic fistulae(P<0.05).There were no significant differences in terms of age,body mass index,hypertension,preoperative hemoglobin,albumin,total protein,TNM stage,maximum tumor diameter,tumor differentiation degree,ISR procedure,operation time,intraoperative blood loss,submesenteric artery dissection level,and anastomotic height between the 2 groups(P>0.05).Multifactorial analysis suggested that male,preoperative neoadjuvant radiotherapy,inflammatory bowel disease,diabetes and postoperative anastomotic fistula were independent risk factors for anastomotic stenosis(P<0.05).Conclusion Male,preoperative neoadjuvant radiotherapy,inflammatory bowel disease,diabetes,postoperative anastomotic fistula may induce anastomotic stenosis in patients with low colorectal cancer after ISR,and corresponding intervention measures should be taken to reduce the incidence of anastomotic stenosis.

关 键 词：低位 结直肠癌 经括约肌间切除术 吻合口狭窄 影响因素 

分 类 号：R735.37[医药卫生—肿瘤] R735.35[医药卫生—临床医学]