微创直肠癌Dixon术后吻合口愈合的相关因素及对策分析

Related factors and countermeasures of anastomotic healing after minimally invasive Dixon operation for rectal cancer

目的探讨微创直肠癌低位前切除(Dixon)术后吻合口愈合的相关因素及对策。方法回顾性选取微创直肠癌Dixon术患者150例,观察患者吻合口愈合情况并分析其相关因素及防治对策。结果150例患者吻合口愈合130例(86.67%)、吻合口瘘20例(13.33%);单因素分析结果显示,年龄、体重指数、术前白蛋白、糖尿病、距肛缘距离、手术时间、放置肛管与患者术后吻合口愈合有关(P<0.05);Logistic回归分析结果显示,年龄>60岁、体重指数>25 kg/m2、术前白蛋白≤35 g/L、糖尿病、距肛缘距离≤7 cm、手术时间>270 min、未放置肛管是患者术后吻合口愈合的独立危险因素(P<0.05)。结论微创直肠癌Dixon术后吻合口愈合与年龄>60岁、体重指数>25 kg/m2、术前白蛋白≤35 g/L、糖尿病、距肛缘距离≤7 cm、手术时间>270 min、未放置肛管等危险因素有关,应重视和加强危险因素的防控,以防治吻合口瘘的发生。

Objective To discuss the related factors and countermeasures of anastomotic healing after minimally invasive low anterior resection(Dixon)operation for rectal cancer.Methods 150 patients with cervical cancer were selected retrospectively from March,2014 to March,2018 in The First Hospital of Qinhuangdao City,and the anastomotic healing of patients were observed and the related factors and preventive measures were analyzed.Results 130 cases(86.67%)of anastomotic healing and 20 cases(13.33%)of anastomotic fistula were found in 150 cases.The single factor analysis results showed that age,body mass index,preoperative albumin,diabetes,distance from the anal margin,operation time,anal canal were related to the postoperative anastomotic healing of patients(P<0.05).A Logistic regression analysis results showed that,age>60,body mass index>25 kg/m2,preoperative albumin≤35 g/L,diabetes,distance from anus margin≤7 cm,operation time>270 min,no anal canal were the independent risk factors for postoperative anastomotic healing of patients(P<0.05).Conclusion The anastomotic healing after minimally invasive Dixon operation for rectal cancer was related to the risk factors of age>60,body mass index>25 kg/m2,preoperative albumin≤35 g/L,diabetes,distance from anus margin≤7 cm,operation time>270 min,no anal canal,and attentionshould be paid to them so as to strengthen the prevention and control of the risk factors and prevent the occurrence of anastomotic fistula.