经腹腔镜下行直肠癌低位前切除术后吻合口瘘的危险因素分析

Risk factors of anastomotic fistula after low anterior resection of rectal cancer were analyzed by laparoscopy

目的分析经腹腔镜下行直肠癌低位前切除术后吻合口瘘的危险因素,为吻合口瘘的早期防治提供理论依据。方法本研究针对2017年4月～2018年4月于我院接受腹腔镜下直肠癌低位前切除术治疗的300例患者的临床资料进行回顾性分析。根据患者术后是否出现了吻合口瘘并发症将其分为研究组和对照组,针对两组患者的临床资料进行对比分析,利用单因素和多因素回归分析法分析吻合口瘘发生的危险因素。结果两组患者在年龄、肿瘤病理类型、组织学类型、分化程度、以及Dukes分期等指标的比较上差异无统计学意义(P>0.05),单因素结果显示吻合口瘘的危险因素包括性别、BMI、肿瘤与肛缘距离、术前合并肠梗阻、术前白蛋白、手术时间以及肿瘤大小(P<0.05);多因素结果显示,影响患者出现术后吻合口瘘的危险因素包括患者的性别、肥胖、肿瘤下缘距肛缘距离以及术前白蛋白异常(P<0.05)。结论经腹腔镜下行直肠癌低位前切除术患者出现术后吻合口瘘的危险因素包括患者的性别、肥胖、肿瘤下缘距肛缘距离以及术前白蛋白异常,应当于临床中给予高度重视。

Objective To explore risky factors of of anastomotic fistula,we analyzed the clincal factor of patients who received laparoscopic low anterior resection.Methods 300 patients who have received laparoscopic low anterior resection of rectal cancer were included in our hospital from April 2017 to April 2018.Research group and control group were classified according to whether the patient has postoperative anastomotic fistula,.single factor analysis and multifactor regression analysis were used to analyze the risk factors of anastomotic fistula by using the.Results No significant difference was detected between the two groups in age,tumor pathologic type,histological type,differentiation degree,and Dukes staging index(P>0.05).Single factor analysis shows that gender,BMI,tumor and anal edge distance,merging,intestinal obstruction,preoperative albumin,operation time and tumor size are the risk factors of anastomotic fistula(P<0.05).Multifactor analysis shows that gender,obesity,distance between tumor lower margin and anal margin,and abnormal preoperative albumin are the risk factors(P<0.05).Conclusion We find that gender,obesity,distance of tumor from anal edge and abnormal preoperative albumin are the risk factors of anastomotic fistula for colorectal cancer patients who receive laparoscopiclow rectal cancer resection.High attention should be paid to these risks factors in clinic treatment.