摘要
目的探讨直肠癌低位前切除术(low anterior resection,LAR)后吻合口瘘(anastomotic leakage,AL)的相关影响因素。方法回顾分析宁夏医科大学总医院结直肠外科于2012年1月至2019年8月收治的504例确诊为低位直肠癌并行LAR术后患者的临床资料,分析影响AL发生的相关因素。结果低位直肠癌LAR术后AL发生率为6.0%。单因素分析显示,AL的发生在性别、术前有无肠梗阻、手术方式(开腹手术及腹腔镜手术)、肿瘤远端距肛缘距离、术后是否贫血、术后白蛋白含量等方面,差异均有统计学意义(P均<0.05);多因素分析显示,男性、术前有肠梗阻、肿瘤远端距肛缘距离≤5 cm、腹腔镜手术、术后白蛋白含量≤30 g·L^(-1)是低位直肠癌LAR术后发生AL的独立危险因素(P均<0.05)。结论男性、术前有肠梗阻、肿瘤位置较低、行腹腔镜手术及术后营养不良的直肠癌患者,LAR术后AL的发生风险较高,应实施相应预防措施,以降低AL发生率。
Objective To investigate the related influencing factors of anastomotic leakage after low anterior resection of rectal cancer.Methods The clinical data of 504 patients with low rectal cancer who underwent low anterior resection in the Department of colorectal surgery,General Hospital of Ningxia Medical University from January 2012 to August 2019 were retrospectively analyzed.The independent risk factors of anastomotic leakage were screened out by statistical methods and analyzed.Results The incidence of anastomotic leakage was 6.0%in patients with low rectal cancer.After the single factor analysis,the occurrence of anastomotic leakage was statistically significant with gender,preoperative complicated with ileus,operation method(Laparotomy and laparoscopy assisted surgery).The distal distance of the tumor from the anal margin,postoperative anemia and the post operative albumin content(P all<0.05).The multivariate analysis showed that men,preoperative intestinal obstruction,distal tumor distance from the anal margin≤5 cm,laparoscopic surgery,postoperative albumin content≤30 g·L^(-1) were independent risk factors for anastomotic leakage after anterior resection of low rectal cancer(P all<0.05).Conclusion Rectal cancer patients with male,preoperative bowel obstruction,laparoscopic surgery,low tumor location,and postoperative malnutrition have a higher risk of AL after LAR.Corresponding preventive measures should be implemented to reduce the incidence of AL.
作者
明永静
宋伟
李同同
杨宝
王伟杰
周洁
李海
MING Yongjing;SONG Wei;LI Tongtong;YANG Bao;WANG Weijie;ZHOU Jie;LI Hai(Ningxia Medical University,Yinchuan 750004,China;Department of Colorectal Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)
出处
《宁夏医科大学学报》
2021年第12期1230-1235,共6页
Journal of Ningxia Medical University
基金
国家自然科学基金项目(81960526)。
关键词
低位直肠癌
吻合口瘘
影响因素
low rectal cancer
anastomotic leakage
influencing factors
