腹腔镜直肠癌Dixon术后吻合口瘘的危险因素分析

Related risk factors analysis of postoperative anastomotic fistula by laparoscopic assisted colorectal cancer Dixon

目的探讨腹腔镜辅助下直肠癌Dixon术后吻合口痿的相关危险因素。方法对238例直肠癌患者的临床资料进行回顾性分析，其中18例患者术后吻合口瘘（吻合口瘘组），220例患者未发生吻合口瘘（吻合口未瘘组），对两组患者相关因素进行单因素非条件和多因素非条件的Logistic回归分析。结果单因素分析结果显示术前白蛋白水平、合并2型糖尿病、吻合口位置、术前新辅助治疗、肿瘤大小、是否放置肛管、肿瘤的分化程度与直肠癌Dixon术后吻合口瘘具有相关性，差异有统计学意义（P〈0．05）；多因素非条件Logistic回归分析显示术前白蛋白水平、吻合口的位置、术前新辅助治疗是腹腔镜Dixon术后发生吻合口瘘的独立危险因素；其中术后放置肛管是其保护因素之一。结论对腹腔镜辅助下直肠癌患者相关危险因素积极进行干预，对防治术后吻合口瘘的发生具有重要的临床意义。

Objective To investigate the related risk factors of postoperative anastomotic fistula by laparoscopic assisted colorectal cancer Dixon. Methods The clinical data of 238 patients with rectal cancer were retrospective analyzed, there were 18 cases of postoperative anastomotic fistula （anastomotic fistula group） , the rest of 220 patients were no anastomotic fistula （no anastomotic fistula group）. Both groups received single factor and multifactor non-conditional Logistic regression analysis. Results Single factor analysis showed that preoperative albumin level, combined with type 2 diabetes, anastomotic location, preoperative neoadjuvant therapy, tumor size, placement of anal canal, tumor differentiation degree were closely correlated with postoperative anastomotic fistula, the differences were significant （ P 〈 0. 05 ） ; Multiple factors unconditioned Logistic regression analysis showed that preoperative albumin level, anastomotic location, preoperative neoadjuvant therapy were laparoscopic Dixon independent risk factors for postoperative anastomotic fistula, placement of anal canal was one of the important protection factors. Conclusions Positive intervention measures are put into effect for laparoscopic assisted colorectal cancer Dixon. It has important clinical significance for the prevention and treatment of postoperative anastomotic fistula.