结直肠癌患者腹腔镜根治术后并发症的影响因素研究

The study of influencing factors for postoperative complications of laparoscopic radical surgery for colorectal cancer patients

目的:探讨结直肠癌患者腹腔镜根治术后并发症的影响因素,为提高手术疗效提供有利依据。方法:回顾分析2011年1月至2013年1月156例结直肠癌患者的临床资料,根据有无并发症分为无并发症组与并发症组,通过单因素及多因素分析筛选并发症的影响因素。结果:单因素分析显示,患者的性别、发病年龄、术前合并症、术者手术经验、新辅助治疗、手术时间、肿瘤位置及TNM分期与结直肠癌腹腔镜根治术后并发症相关。多因素回归分析显示,性别、术前合并症、术者手术经验、肿瘤位置及TNM分期是影响结直肠癌患者腹腔镜根治术后并发症发生的独立危险因素。并发症组患者的住院时间明显长于无并发症组(P<0.05)。结论:性别、术前合并症、术者手术经验、肿瘤位置及TNM分期是影响结直肠癌患者腹腔镜根治术后并发症发生的独立危险因素,术中应尤其注意伴有并发症危险因素的患者,以提高手术疗效。

Objective ： To explore the influencing factors for postoperative complications of laparoscopic radical surgery for colo- rectal cancer patients. Methods：The clinical data of 156 patients who suffered from colorectal cancer and underwent laparoscopic radi- cal surgery from Jan. 2011 to Jan. 2013 were retrospectively analyzed. All the patients were divided into complication group and non- complication group according to the presence or absence of complications. Influencing factors of complications were screened by univari- ate and multivariate analysis. Results ： Univariate analysis showed that the patients ＇ gender, the age of onset, preoperative comorbidities, surgeon＇ s surgical experience, neoadjuvant therapy, operative time, tumor location and TNM stage were associated with complications of laparoscopic radical surgery for colorectal cancer patients. Multivariate logistic regression analysis showed that sex, preoperative comor- bidities, surgeon＇ s surgical experience, tumor location and TNM stage were independent risk factors for postoperative complications in the patients with laparoscopic radical surgery for colorectal cancer. The hospital stay of the complication group was significantly longer than that of non-complication group （ P 〈 0.05 ）. Conclusions ： Sex, preoperative comorbidities, surgeon＇ s surgical experience, tumor lo- cation and TNM stage were independent risk factors for postoperative complications in the patients with laparoseopic radical surgery for colorectal cancer. In order to improve surgical treatment, in operation particular attention should be paid to the patients with complica- tions risk factors.