全直肠系膜切除术(TME)后吻合口瘘相关因素分析

Related factors of anastomotic leakage after total meaorectal excision

目的:探讨全直肠系膜切除术(TME)后吻合口瘘的相关因素。方法:对近13年来收治的514例直肠癌行TME患者的临床资料进行回顾性分析。结果:514例直肠癌共发生吻合口瘘43例,发生率为8.3%。其中男性患者,吸烟酗酒者,贫血低蛋白者,糖尿病及伴有慢性阻塞性呼吸系统疾病者,肿瘤距肛门距离小于7cm者,肿廇直径>4cm者,术前放、化疗患者及手工吻合者易发生吻合口瘘;而不同的肿瘤病理分型及临床分期吻合口瘘的发生无明显不同。结论:直肠癌行TME术后吻合口瘘发生率与患者自身因素、肿瘤本身、手术者的操作技巧等因素有关。

Objective：To investigate relative factors of anastomotic leakage after total meaorectal excision. Methods：Clinical data of 514 cases in recent 13 years of anastomotic leakage after total meaorectal excision were retrospectively analyzed. Results： Of the 514 cases ,43 cases developed anastomotic leakage, the occurrence rate was 8.3%. The patients with male, smoking and alcohol abuse,anaemia and hypoproteinemia, diabetes, COPE, distance of tumor from anal verge less than 7cm and tumor diameter more than 4cm, preoperative radiotherapy and chemo therapy, hand- made anastomosis developed anastomotic leakage easily, while the patients with different tumor pathology type and clinical stage had no relation in anastomotic leakage occurrence. Conclusion ：The rate of anastomotic leakage after TME was related to personal factors, tumor factors, technique skill of operator.