直肠癌低位前切除术后吻合口瘘发生相关因素分析

doi:10.3969/j.issn.1006-7795.2017.05.018

首都医科大学学报 ›› 2017, Vol. 38 ›› Issue (5): 727-732.doi: 10.3969/j.issn.1006-7795.2017.05.018

直肠癌低位前切除术后吻合口瘘发生相关因素分析

徐谊, 赵晓牧, 孙武青, 马健, 王岳月, 王今

首都医科大学附属北京友谊医院普外科国家消化系统疾病临床医学研究中心, 北京 100050

收稿日期:2017-05-12 出版日期:2017-09-21 发布日期:2017-10-18
通讯作者: 王今 E-mail:iamwang_jin@sina.com
基金资助:
首都卫生发展科研专项项目（2014-2-2022）。

Risk factors on anastomotic leakage after low anterior resection of rectal cancer

Xu Yi, Zhao Xiaomu, Sun Wuqing, Ma Jian, Wang Yueyue, Wang Jin

Department of Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center For Digestive Diseases, Beijing 100050, China

Received:2017-05-12 Online:2017-09-21 Published:2017-10-18
Supported by:
This study was supported by Capital Health Research and Development of Special (2014-2-2022).

摘要/Abstract

摘要： 目的探究直肠癌低位前切除术后发生吻合口瘘的危险因素，为临床上吻合口瘘的防治提供依据，从而降低瘘的发生率。方法回顾性分析2013年1月1日至2017年3月31日首都医科大学附属北京友谊医院261例行直肠癌低位前切除术（low anterior resection，LAR）病人的临床资料。分别行单因素和Logistic多因素回归分析吻合口瘘的相关危险因素。结果吻合口瘘发生率为6.89%（18/261）。多因素分析显示，新辅助放射治疗联合化学药物治疗（以下简称放化疗）（OR=3.498，P=0.024）、联合其他器官手术（OR=10.834，P=0.003）与术后吻合口瘘相关。结论新辅助放化疗、联合其他器官手术为直肠癌低位前切除术后吻合口瘘的独立危险因素。针对相关危险因素，可以采取积极有效的防治措施，从而降低吻合口瘘的发生。

关键词: 直肠癌, 低位前切除, 吻合口瘘, 危险因素

Abstract: Objective To investigate the risk factors on anastomotic leakage after low anterior resection of rectal cancer so as to provide a basis for the prevention and treatment of anastomotic leakage, thus reducing the incidence of leakage. Methods The data of 261 rectal cancer patients undergoing low anterior resection from January 1st 2013 to March 31st 2017 were recruited. All patients experienced a total mesorectal excision (TME) operation. χ² test was performed for univariate analysis, and Logistic regression test was carried out for multivariate correlation analysis. Results The incidence of anastomotic leakage was 6.89% (18/261). Multivariate analysis showed that the occurrence of anastomotic leakage was closely correlated to neoadjuvant chemoradiation (OR=3.498,P=0.024) and combined with other organ surgery (OR=10.834, P=0.003). Conclusion Neoadjuvant chemoradiation and combined with other organ surgery were considered as independent risk factors for anastomotic leakage after anterior resection of rectal cancer. According to the relevant risk factors, the effective measures should be taken to reduce the incidence of anastomotic leakage.

Key words: rectal cancer, low anterior resection, anastomotic leakage, risk factors

中图分类号:

R753.3

徐谊, 赵晓牧, 孙武青, 马健, 王岳月, 王今. 直肠癌低位前切除术后吻合口瘘发生相关因素分析[J]. 首都医科大学学报, 2017, 38(5): 727-732.

Xu Yi, Zhao Xiaomu, Sun Wuqing, Ma Jian, Wang Yueyue, Wang Jin. Risk factors on anastomotic leakage after low anterior resection of rectal cancer[J]. Journal of Capital Medical University, 2017, 38(5): 727-732.

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直肠癌低位前切除术后吻合口瘘发生相关因素分析

Risk factors on anastomotic leakage after low anterior resection of rectal cancer

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