429例腹腔镜结、直肠切除术中转开腹风险因素分析

Risk factors analysis of conversion to open procedure in 429 patients undergoing laparoscopic colorectal surgery

目的:分析腹腔镜结直肠切除术中转开腹风险因素。方法:对429例临床资料进行回顾性研究。结果:中转开腹68例,中转开腹率15.85%,应用Logistic回归分析确定腹腔镜结直肠切除术中转开腹风险因素为年龄≥65(CI=2.115,P<0.05),体重指数BMI≥25(CI=2.907,P<0.01),手术例数≤25例(CI=1.900,P<0.05),有腹部手术史(CI=3.205,P<0.05),有转移(CI=30.115,P<0.01),肿瘤大小≥6cm(CI=8.954,P<0.05)。结论:术前明确腹腔镜结直肠切除术中转开腹风险因素可以评估手术难度,减少中转开腹率。

Objective：To analyze the risk factors of conversion to open surgery in laparoscopic colorectal surgery＇. Methods： Retrospective study was performed in 429 patients,who underwent laparoscopic colorectal surgery at our department. Resulls：68 patients were converted to open surgery,and the conversion rate was 15.85%. The risk iactors of laparoscopic colorectal surgery to open surgeryincluded age≥ 65 （ CI = 2.115, P 〈 0.05 ）, BMI≥ 25 （ CI = 2. 907, P 〈 0.01 ）, operation number ≤ 25 （ CI = 1. 900, P 〈 0.05 ）, abdominal operation history （ CI = 3. 205, P 〈 0.05 ）, invasion or metastasis （ CI = 30, 115, P 〈 0.01 ） and diameter of tumor≥6cm （ CI = 8. 954,P 〈 0.05 ）. Conclusions ：To evaluate the risk factors preoperatively can decrease the conversion rate.