肿瘤患者发生非计划再次手术的原因和影响因素

Causes and affecting factors of unplanned reoperations in cancer patients

目的 探讨肿瘤患者发生非计划再次手术的原因及其影响因素.方法 回顾性分析2012年11月1日至2013年10月31日,中国医学科学院肿瘤医院手术和非计划再次手术患者的临床资料.采用Logistic回归模型分析发生非计划再次手术的影响因素.结果 共行手术16 362例,其中非计划再次手术126例,发生率为0.77％.位居前3位发生非计划再次手术的原因为术后出血或血肿44例（34.92％）、切口感染或不愈合37例（29.37％）,吻合口瘘14例（11.11％）.Logistic回归分析结果显示,肿瘤分类、手术级别和性别为发生非计划再次手术的独立影响因素（均P＜0.05）.结论 发生非计划再次手术的主要原因为术后出血或血肿、切口感染或不愈合以及吻合口瘘.肿瘤分类、手术级别和性别是发生非计划再次手术的独立影响因素.

Objective To investigate the causes and affecting factors of unplanned reoperations in cancer patients.Methods All patients,who underwent surgery and unplanned surgical reoperations in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College between November 1,2012 and October 1,2013,were included in this study.The causes and affecting factors of unplanned reoperations were retrospectively analyzed with logistic regression model.Results A total of 16,362 operations were performed in that period,in which 126 cases underwent unplanned reoperation.The incidence rate of unplanned reoperation was 0.77％.The top three causes for unplanned reoperation were bleeding or hematoma in 44 cases （34.92％）,wound infection or split in 37 cases （29.37％）,and anastomotic leak in 14 cases （11.11％）.Logistic regression analysis showed that tumor classification,surgery grade and gender were independent factors for the unplanned reoperations.Conclusions The main causes of unplanned reoperation are bleeding or hematoma,wound infection or split and anastomotic leak.Tumor classification,surgery grade and gender are the independent factors for unplanned reoperations.