摘要: |
[摘要] 目的 分析腹腔镜直肠癌超低位前切除术吻合口漏的危险因素。方法 回顾性分析2012年6月至2021年2月由同一手术团队收治的381例行直肠癌超低位前切除术患者的临床资料,分析影响术后吻合口漏发生的危险因素。结果 直肠癌超低位前切除术后吻合口漏的总体发生率为9.19%。单因素分析结果显示吻合口漏在性别、新辅助同步放化疗、是否保留左结肠动脉(LCA)、侧方淋巴结清扫、吻合口距肛缘距离及肿瘤N分期的分组中存在差异。进一步行多因素logistic回归分析结果显示,术后吻合口漏发生的独立危险因素包括新辅助同步放化疗[OR(95%CI):5.213(2.214~12.272);P=0.000]、未保留LCA[OR(95%CI):2.725(1.186~6.261);P=0.018]、吻合口距肛缘距离≤2 cm[OR(95%CI):3.104(1.126~8.559);P=0.029]。结论 新辅助同步放化疗、未保留LCA及吻合口距肛缘距离≤2 cm是腹腔镜直肠癌超低位前切除术后吻合口漏发生的独立危险因素。 |
关键词: 直肠癌超低位前切除术 吻合口漏 新辅助同步放化疗 |
DOI:10.3969/j.issn.1674-3806.2022.07.02 |
分类号:R 735.3+7 |
基金项目:吴阶平医学基金会临床科研专项资助基金课题(编号:320.6750.2021-04-2) |
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Analysis of risk factors for anastomotic leakage in laparoscopic ultra-low anterior resection of rectal cancer: experience of 381 cases in a single institution |
HU Gang, LIU Jun-guang, MEI Shi-wen, et al.
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Department of Colorectal Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Abstract: |
[Abstract] Objective To analyze the risk factors for anastomotic leakage in laparoscopic ultra-low anterior resection of rectal cancer. Methods The clinical data of 381 patients undergoing ultra-low anterior resection of rectal cancer who were treated by the same surgical team from June 2012 to February 2021 were retrospectively analyzed. The risk factors affecting postoperative anastomotic leakage were analyzed. Results The overall incidence of anastomotic leakage after ultra-low anterior resection of rectal cancer was 9.19%. The results of univariate analysis showed that there were differences in the grouping of gender, neoadjuvant chemoradiotherapy, whether to preserve the left colonic artery(LCA), lateral lymph node dissection, the distance from anastomosis to anal margin and N stage. The results of further logistic multivariate regression analysis showed that the independent risk factors of postoperative anastomotic leakage included neoadjuvant chemoradiotherapy[OR(95%CI): 5.213(2.214-12.272); P=0.000], non-preservation of LCA[OR(95%CI): 2.725(1.186-6.261); P=0.018], distance from anastomosis to anal margin≤2 cm[OR(95%CI): 3.104(1.126-8.559); P=0.029]. Conclusion Neoadjuvant chemoradiotherapy, non-preservation of LCA and distance from anastomosis to anal margin≤2 cm are the independent risk factors of anastomotic leakage after laparoscopic ultra-low anterior resection of rectal cancer. |
Key words: Ultra-low anterior resection of rectal cancer Anastomotic leakage Neoadjuvant chemoradiotherapy |