摘要
目的对全直肠系膜切除术(TME)后发生吻合口瘘的影响因素进行分析并据此提出相应的预防措施,为TME后患者预后提供参考。方法回顾性分析2008年3月至2013年5月间接受TME治疗的461例患者病例资料,分析影响吻合口瘘发生的因素,包括年龄、性别、病理类型、术前是否合并肠梗阻、是否合并糖尿病、肿瘤肛缘距离、手术时长、有无淋巴结转移、Dukes分期、吻合方式等。结果 461例患者中,32例患者(6.9%)发生吻合口瘘,吻合口瘘的发生与术前合并肠梗阻、病理类型、肿瘤肛缘距离和手术时长相关(P<0.05);与年龄、性别、是否合并糖尿病、有无淋巴结转移、Dukes分期、吻合方式等因素无关(P>0.05)。32例发生吻合口瘘的患者中,24例经过保守治疗后痊愈,7例行横结肠造口后治愈,1例死亡。结论病理类型、术前合并肠梗阻、肿瘤肛缘距离和手术时长等因素是吻合口瘘发生的危险因素,这对临床预测及预防吻合口瘘的发生具有指导价值。
Objective To analyze influence factors of anastomotic fistula after total mesorectal exci- sion （TME） for colorectal cancer and put forward corresponding preventive measures for prognosis after TME reference. Methods From March 2008 to May 2013, clinical data of 461 patients were analyzed retrospec- tively, the factors affecting anastomotic fistula, including gender, age, anatomizes, pathological type, pre- operative obstruction, diabetes, tumor from the anal verge, surgery duration, lymph node metastasis, Dukes staging were analyzed. Results Thirty-two patients （6. 9% ） were happened with anastomotic fistula. Anastomotic fistula was associated with preoperative bowel obstruction, histological type, tumor anal margin long distance （ P 〈 0. 05 ） ; it was not associated with gender, age, anatomizes, diabetes, lymph node me- tastasis, Dukes stage and other factors （ P 〉 0.05 ） ; Among these 32 patients with anastomotic fistula, 24 cases were cured after conservative treatment, 7 cases were cured after transverse colostomy, and 1 patient was died. Conclusions Preoperative bowel obstruction, histological type, tumor anal margin long distance are the risk factors for anastomotic fistula. These results had guiding value in predicting and preventing anastomotic fistula.
出处
《中国肿瘤临床与康复》
2014年第2期175-177,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
结直肠肿瘤
全直肠系膜切除术
吻合口瘘
影响因素
Colon neoplasms
Total mesorectal excision
Anastomotic fistula
Influencingfactors
