腹腔镜辅助胃癌根治术后吻合口瘘危险因素分析  

Analysis of Risk Factors of Anastomotic Leakage After Laparoscopic Assisted Radical Gastrectomy

作　　者：公绪飞 程辉 訾力[2] 郭明晓[2] GONG Xufei;CHENG Hui;ZI Li;GUO Mingxiao(Postgraduate Base of Linyi People′s Hospital,Jinzhou Medical University;Department of Gastrointestinal Surgery,Linyi People′s Hospital,Linyi 276000 China)

机构地区：[1]锦州医科大学临沂市人民医院研究生基地 [2]临沂市人民医院胃肠外科,山东临沂276000

出　　处：《锦州医科大学学报》2024年第6期42-46,共5页Journal of Jinzhou Medical University

基　　金：山东省自然科学基金面上项目,项目编号:ZR2021MH362;山东省自然科学基金面上项目,项目编号:202304010731。

摘　　要：目的探讨腹腔镜辅助胃癌根治术后吻合口瘘(anastomotic leakage,AL)的相关危险因素。方法回顾性分析2022年1月至2023年12月于临沂市人民医院普外科行腹腔镜辅助胃癌根治术的281例患者的临床资料,依据有无AL的发生分为AL组(n=14)和非AL组(n=267)。收集患者相关临床资料,单因素分析采用χ^(2)检验,多因素分析采用二元Logistic回归分析,P<0.05为差异有统计学意义。结果本研究中腹腔镜辅助胃癌根治术后14例患者发生AL,发生率4.98%。单因素分析结果提示:年龄、术前肺功能不全、术前新辅助治疗史、肿瘤侵及贲门、切除程度、术中出血量差异有统计学意义(P<0.05)。多因素分析结果提示:患者的年龄(P=0.007)、肿瘤侵及贲门(P=0.015)、切除程度(P=0.003)为腹腔镜辅助胃癌根治术后AL的独立危险因素(P<0.05)。结论年龄不小于65岁、肿瘤侵及贲门及术式为全胃切除为腹腔镜辅助胃癌根治术后AL的独立危险因素,外科医师应对以上因素采取一定预防措施,以期降低AL的发生率。Objective To investigate the risk factors of anastomotic leakage(AL)after laparoscopic assisted radical gastrectomy for gastric cancer.Methods Clinical data of 281 patients who underwent laparoscopic-assisted radical gastectomy in the Department of General Surgery of Linyi People′s Hospital from January 2022 to December 2023 were retrospectively analyzed.According to the occurrence of AL,they were divided into AL group(n=14)and non-AL group(n=267).Relevant clinical data were collected.χ^(2)test was used for univariate analysis and binary Logistic regression analysis was used for multivariate analysis.P<0.05 was considered statistically significant.Results In this study,AL occurred in 14 patients after laparoscopic assisted radical gastrectomy,with an incidence of 4.98%.Univariate analysis showed that there were significant differences in age,preoperative pulmonary insufficiency,preoperative history of neoadjuvant therapy,tumor invasion of cardiac,resection degree,and intraoperative blood loss(P<0.05).The results of multivariate analysis suggested that the age of the patient(P=0.007),the tumor invasion of the cardia(P=0.015),and the degree of resection(P=0.003)were independent risk factors for AL after laparoscopic assisted radical gastrectomy(P<0.05).Conclusion Age no less than 65 years old,tumor invasion of the cardia and total gastrectomy are independent risk factors for AL after laparoscopic assisted radical gastrectomy.Surgeons should take certain preventive measures against these factors in order to reduce the incidence of AL.

关 键 词：胃癌 吻合口瘘 危险因素 

分 类 号：R735.2[医药卫生—肿瘤]