腹腔镜胃癌根治术患者术后非计划再次手术的影响因素分析  

Analysis of Influencing Factors for Unplanned Secondary Surgery in Patients After Laparoscopic Radical Surgery of Gastric Cancer

作　　者：简文红 劳景茂[1] 韦小波[1] Jian Wenhong;Lao Jingmao;Wei Xiaobo(Department of Gastrointestinal Surgery,The First People's Hospital of Qinzhou,Qinzhou 535000,Guangxi Zhuang Autonomous Re-gion,China)

机构地区：[1]广西钦州市第一人民医院胃肠外科,广西壮族自治区钦州535000

出　　处：《中国社区医师》2024年第34期64-66,共3页Chinese Community Doctors

基　　金：广西壮族自治区临床重点专科建设项目(普通外科),编号:桂卫医发[2022]17号;钦州市科学研究与技术开发计划项目(编号:20202730);广西钦州市科学技术局科技攻关课题(编号:20232532)。

摘　　要：目的:探讨腹腔镜胃癌根治术患者术后非计划再次手术(USO)的影响因素。方法:选取2013年8月—2023年12月于广西钦州市第一人民医院进行腹腔镜胃癌根治术的638例患者作为研究对象,统计患者术后行USO人数以及手术原因,根据腹腔镜胃癌根治术后是否行USO将638例患者分为手术组、未手术组,比较两组临床资料,分析腹腔镜胃癌根治术患者术后USO的影响因素。结果:638例患者术后USO 21例,发生率为3.29%;手术原因包括腹腔内出血、十二指肠残端漏、肠梗阻、吻合口漏等。腹腔镜胃癌根治术患者术后USO的影响因素有性别、年龄、术前合并症发生情况、术前白蛋白水平、胃切除范围、术后并发症发生情况(P<0.05)。术前有合并症、术前白蛋白<35 g/L、全胃切除及术后有并发症是腹腔镜胃癌根治术患者术后USO的独立危险因素(P<0.05)。结论:腹腔镜胃癌根治术患者术后USO的主要原因为腹腔内出血、十二指肠残端漏、肠梗阻、吻合口漏等,独立危险因素包括术前有合并症、术前白蛋白<35 g/L、全胃切除及术后有并发症。Objective:To explore the influencing factors for unplanned secondary surgery(USO)in patients after laparoscopic radi⁃cal surgery of gastric cancer.Methods:A total of 638 patients who underwent laparoscopic radical surgery of gastric cancer in the First People's Hospital of Qinzhou from August 2013 to December 2023 were selected as the study subjects.The number of patients who underwent USO after surgery and the causes for surgery were counted.These 638 patients were divided into surgery group and non-surgery group according to whether USO was performed after laparoscopic radical surgery of gastric cancer.The clinical data of the two groups were compared.The influencing factors for postoperative USO in patients undergoing laparoscopic radical surgery of gastric cancer were analyzed.Results:Among 638 patients,21 cases underwent postoperative USO,with an incidence of 3.29%.The causes for surgery included intraabdominal bleeding,duodenal stump leakage,intestinal obstruction,and anastomotic leakage.The influencing factors for postoperative USO in patients undergoing laparoscopic radical surgery of gastric cancer included gender,age,occurrence of preoperative complications,preoperative albumin level,extent of gastric resection,and occurrence of postoperative complications(P<0.05).Preoperative comorbidities,preoperative albumin<35 g/L,total gastrectomy and postoperative complica⁃tions were independent risk factors for postoperative USO in patients undergoing laparoscopic radical surgery of gastric cancer(P<0.05).Conclusions:The main causes of postoperative USO in patients undergoing laparoscopic radical surgery of gastric cancer are intraabdominal bleeding,duodenal stump leakage,intestinal obstruction and anastomotic leakage.The independent risk factors include preoperative comorbidities,preoperative albumin<35 g/L,total gastrectomy and postoperative complications.

关 键 词：腹腔镜胃癌根治术 非计划再次手术 影响因素 

分 类 号：R735.2[医药卫生—肿瘤]