低位直肠癌术后吻合口漏多因素分析及防治

The Multivariate Factors Analysis and Prevention of Anastomotic Leakage in Postoperative Low Rectal Cancer

目的探讨直肠癌术后吻合口漏的影响因素及有效的防治措施。方法回顾我院2007年1月～2012年1月收治并行Dixons手术的568例低位直肠癌患者临床资料,对吻合口漏影响因素进行Logistic回归分析。结果术后吻合口漏发生率为2.46%(14/568),经统计分析,吻合口漏与肿瘤位置、Dukes分期密切相关。全部病例均治愈出院,无死亡及重大并发症。结论低位直肠癌术后吻合口漏的发生与多个危险因素有关。充分的术前准备,精细的手术操作,通畅引流是预防吻合口漏的重要措施。

Objective To study the influencing factors and prevention of anastomotic leakage after rectal cancer surgery. Method The data of 568 cases of low rectal cancer, admitted from January 2007 to January 2012, underwent Dixons surgery were made Logistic regression analysis. Results 14 cases were found anastomotic leakage, and the incidence rate was 2.46% （14/568）. Factor analysis result showed gender and age was not associated with anastomotic leakage （ P 〉 0.05 ）, but tumor location and Dukes stage was closely related to it （ P 〈 0.05 ）, and both were the major risk factors of anastomotic leakage according non-conditional logistic regression analysis. All patients were cured and no death and other major complications. Conclusions There were a lot of risk factors to anastomotie leakage of low rectal cancer surgery. Adequate preoperative preparation, skilled surgical operation, unobstructed drainage is the important measure for prevention of anastomotic leakage.