右半结肠癌患者腹腔镜全结肠系膜切除术后发生肠梗阻的影响因素分析

Influencing factors of intestinal obstruction in patients with right colon cancer after laparoscopic complete mesocolic excision

目的:分析右半结肠癌患者腹腔镜全结肠系膜切除(CME)术后发生肠梗阻的影响因素。方法:回顾分析2017年1月至2020年1月于河南大学淮河医院完成腹腔镜CME治疗的234例右半结肠癌患者的临床资料,记录术后肠梗阻发生情况,设计一般资料调查问卷,调查患者相关情况并记录,将全部可能的影响因素纳入后,经单因素与多因素分析找出右半结肠癌腹腔镜CEM术后肠梗阻发生的影响因素。结果:纳入的234例右半结肠癌患者,腹腔镜CME术后20例发生肠梗阻,肠梗阻发生率为8.55%(20/234);经单因素与多项Logistic回归分析检验结果显示,TNM分期高、淋巴结转移、肠梗阻史、营养不良均是右半结肠癌患者腹腔镜CME术后肠梗阻发生的影响因素(OR>1,P<0.05)。结论:右半结肠癌患者经腹腔镜CME术治疗,术后仍存在较高的肠梗阻发生风险,可能与患者TNM分期高、淋巴结转移、肠梗阻史、营养不良等因素有关。

Objective To analyze the influencing factors of intestinal obstruction after laparoscopic complete mesocolic excision(CME)in patients with right colon cancer.Methods The data of 234 patients with right colon cancer who completed laparoscopic CME treatment in Huaihe Hospital of Henan University from January 2017 to January 2020 were retrospectively analyzed,the incidences of postoperative intestinal obstruction were recorded,and a general data questionnaire was designed,the relevant conditions of patients were investigated and recorded,after included all possible influencing factors,single factor and multi-factor analysis were used to find out the influencing factors of intestinal obstruction after laparoscopic CEM of right colon cancer.Results Of the included 234 cases of right colon cancer,20 cases of intestinal obstruction occurred after laparoscopic CME,and the incidence of intestinal obstruction was 8.55%(20/234);the results of single factor and multiple logistic regression analysis showed that high TNM stage,lymph node metastasis,history of intestinal obstruction,and malnutrition were all influencing factors of intestinal obstruction after laparoscopic CME in patients with right colon cancer(OR>1,P<0.05).Conclusions Patients with right colon cancer treated by laparoscopic CME still have a higher risk of intestinal obstruction after surgery,which may be related to patients with high TNM stage,lymph node metastasis,history of intestinal obstruction,malnutrition,etc.