摘要
目的探讨直肠癌全直肠系膜切除术后局部复发的相关影响因素。方法选择接受全直肠系膜切除术的直肠癌患者278例,其中有14例发生术后局部复发。用单因素分析和Logistic回归分析患者术后局部复发的影响因素。结果 278例直肠癌全直肠系膜切除术患者中有14例发生局部复发,占患者总人数的5.04%。直肠癌全直肠系膜切除术后患者的局部复发主要与分化程度、肿瘤穿孔、癌灶距肛缘距离、浸润深度、远切缘长度、淋巴结转移、病理类型、术后放化疗、术前肠梗阻、吻合口瘘等因素有关(P<0.05),与性别、年龄、肿瘤直径、肿瘤分型、手术方式、肿瘤周径无关(P>0.05)。将上述因素纳入Logistic多元回归分析,显示分化程度、肿瘤穿孔、癌灶距肛缘距离、浸润深度、远切缘长度、淋巴结转移、病理类型、术后放化疗、术前肠梗阻、吻合口瘘是引起直肠癌全直肠系膜切除术后局部复发的独立危险因素(P<0.05)。结论直肠癌全直肠系膜切除术后的局部复发率较低,受多种因素的影响,其中吻合口瘘、肿瘤穿孔、分化程度、术前肠梗阻是最重要的影响因素。
Objective To study the related factors of local recurrence of rectal cancer after total mesorectum excision. Methods 278 cases of rectal cancer underwent total mesorectum excision were selected.14 cases among them had postoperative local recurrence,single factor analysis and logistic regression was used to analyze the influence factors of patients with postopera-tive local recurrence.Results 14 cases of 278 cases of colorectal cancer underwent total mesorectum excision had local recur-rence,accounting for 5.04%.Postoperative local recurrence of rectal cancer was mainly related to degree of differentiation,tumor perforation,infiltration depth,anal edge distance between the cutting edge length,lymph node metastasis and pathological types, radiation and chemotherapy after operation,preoperative intestinal obstruction,anastomotic fistula and other factors(P〈0.05), and it was not related to gender,age,tumor diameter,tumor classification,operation method,and tumor diameter (P〉0.05).Tak-ing the above factors into the logistic multivariate regression analysis,it showed that the degree of differentiation,tumor perfora-tion,infiltration depth,anal edge distance between the cutting edge length,lymph node metastasis and pathological type,radiation and chemotherapy after operation,preoperative intestinal obstruction,anastomotic fistula were independent risk factors for local re-currence in colorectal cancer after total mesorectum excision (P〈0.05).Conclusion Local recurrence rate of rectal cancer af-ter total mesorectum excision is low,is influenced by many factors,anastomotic fistula,tumor perforation,degree of differentiation, preoperative intestinal obstruction are the most important influencing factors.
出处
《实用癌症杂志》
2015年第12期1866-1869,共4页
The Practical Journal of Cancer
关键词
直肠癌
全直肠系膜切除
局部复发
影响因素
Colorectal cancer
Total mesorectum excision
Local recurrence
Influencing factors