行微创CME治疗右半结肠癌患者术后并发症发生危险因素研究  

Risk Factors of Postoperative Complications in Patients with Right Colon Cancer Undergoing Minimally Invasive CME

作　　者：岳朝富 王晓波 Yue Zhaofu;Wang Xiaobo(Department of General Surgery,The Fifth People’s Hospital of Pingdingshan,Pingdingshan,Henan,467000,China)

机构地区：[1]平顶山市第五人民医院普外科,河南平顶山467000 [2]楚雄州人民医院肝胆外一科,云南楚雄675000

出　　处：《黑龙江医学》2024年第20期2459-2462,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨行微创完整结肠系膜切除术(CME)治疗右半结肠癌患者术后并发症发生危险因素。方法:回顾性分析2010年1月—2020年1月平顶山市第五人民医院普外科和楚雄州人民医院肝胆外一科收治的282例行腹腔镜下CME治疗右半结肠癌患者的临床资料,分析术后并发症发生情况,采用单因素和多因素分析评价术后并发症发生的独立危险因素。结果:282例患者发生术后并发症共52例(74例次),发生率为18.44%;根据Clavien-Dindo分级划分,Ⅰ级、Ⅱ级及Ⅳ级分别为30例次、42例次、2例次;年龄≥65岁、体质量指数≥28 kg/m^(2)及术前血红蛋白(Hb)水平<100 g/L组术后并发症发生率明显低于年龄<65岁、体质量指数<28 kg/m^(2)及术前Hb水平≥100 g/L组,差异有统计学意义(χ^(2)=8.678、11.943、25.102,P<0.05)。logsitic回归分析结果显示,年龄≥65岁和体质量指数≥28 kg/m^(2)是右半结肠癌腹腔镜下CME术后并发症发生独立危险因素(OR=7.94、5.15,P<0.05)。结论:右半结肠癌腹腔镜下CME术后并发症多为Ⅰ~Ⅱ级;术后并发症的发生与年龄和体质量指数独立相关,其中老年和肥胖人群术后更易出现并发症。Objective:To investigate the risk factors of postoperative complications in patients with right colon cancer undergoing minimally invasive CME.Methods:Clinical data of 282 patients with right colon cancer who underwent laparoscopic CME in the Department of General Surgery of the Fifth People’s Hospital of Pingdingshan City,and the First Department of Hepatobiliary Surgery of the People’s Hospital of Chuxiong City,from January 2010 to January 2020 were retrospectively analyzed.Incidence of postoperative complications was analyzed,and the independent risk factors of postoperative complications were evaluated by univariate and multivariate methods.Results:There were 52 cases for 74 times with postoperative complications in 282 patients and the incidence rate was 18.44%.According to Clavien-Dindo classification,complication with grade I,II and IV were 30 cases,42 cases,and 2 cases respectively.The incidence of postoperative complications of groups with age≥65 years,BMI≥28 kg/m^(2) and preoperative Hb level<100 g/L was significantly lower than groups with age<65 years,BMI<28 kg/m^(2) and preoperative Hb level≥100 g/L,with statistically significant difference(χ^(2)=8.678,11.943,25.102;P<0.05).Logistic regression analysis showed that age≥65 years and BMI≥28 kg/m^(2) were independent risk factors of postoperative complications in patients with right colon cancer by laparoscopic CME(OR=7.94,5.15;P<0.05).Conclusion:The postoperative complications of TME are mostly of grade I~II.The incidence of postoperative complications was independently related to age and body mass index,and the elderly and obese people were more likely to have complications.

关 键 词：右半结肠癌 腹腔镜 完整结肠系膜切除 并发症 危险因素 

分 类 号：R735.35[医药卫生—肿瘤]