论文部分内容阅读
目的探讨腹腔镜辅助下直肠癌前切除术后吻合口瘘发生的危险因素,进而为临床上预防术后吻合口瘘的发生提供参考。方法回顾性分析自2010年1月~2013年12月671例行腹腔镜辅助下直肠癌前切除术患者的临床资料,按照是否发生吻合口瘘分为两组,对年龄、性别、肿瘤下缘距肛缘距离、术前肠道梗阻、高血压病、糖尿病、术后高血糖、术前低蛋白血症、术后低蛋白血症、吻合方式、病理类型、组织学类型、淋巴结转移、肿瘤Dukes分期、肿瘤分化程度等因素进行统计学分析,判断出吻合口瘘发生的危险因素。结果共有48例患者术后发生吻合口瘘,发生率为7.15%。单因素分析显示,肿瘤下缘距肛缘距离、术前肠道梗阻、术后低蛋白血症、术后高血糖等因素与吻合口瘘发生有关(P<0.05),多因素分析支持以上因素为独立危险因素。结论肿瘤下缘距肛缘距离<7 cm、术前肠道梗阻、术后高血糖、术后低蛋白血症是行腹腔镜辅助下直肠癌前切除术后出现吻合口瘘的独立危险因素。
Objective To investigate the risk factors of anastomotic fistula after laparoscopic assisted resection of anterior resection of colorectal cancer and to provide a reference for the prevention of anastomotic leakage after the operation. Methods The clinical data of 671 patients undergoing laparoscopic assisted resection of rectal cancer from January 2010 to December 2013 were retrospectively analyzed. According to whether there was anastomotic fistula or not, the age, sex, Preoperative intestinal obstruction, hypertension, diabetes mellitus, postoperative hyperglycemia, preoperative hypoproteinemia, postoperative hypoproteinemia, anastomosis, pathological type, histological type, lymph node metastasis, tumor Dukes staging, tumor differentiation and other factors were statistically analyzed to determine the risk factors for anastomotic leakage. Results A total of 48 patients developed anastomotic fistula after operation, the incidence was 7.15%. Univariate analysis showed that the distance between the lower edge of the tumor and the anal verge, preoperative intestinal obstruction, postoperative hypoproteinemia, postoperative hyperglycemia and other factors correlated with the occurrence of anastomotic fistula (P <0.05), and multivariate analysis supported the above factors Independent risk factors. Conclusions The lower edge of the tumor from the anal verge is less than 7 cm. Preoperative intestinal obstruction, postoperative hyperglycemia and postoperative hypoproteinemia are the independent risk factors of anastomotic fistula after laparoscopic assisted resection.