低位直肠癌保肛术后低位前切综合征发生的危险因素分析

Analysis of Risk Factors of*Low A nterior Resection Syndrome after Sphincter Preserving Surgery for Low Rectal Cancer

目的探讨低位直肠癌患者行保肛术后出现低位前切综合征(LARS)的危险因素。方法收集2015年1月-2019年12月在本溪市中心医院行保肛手术治疗的低位直肠癌患者421例,对患者的临床资料进行回顾性分析,并依据患者术后是否发生LARS分为LARS组106例和非LARS组315例、分析LARS发生的危险因素。结果单因素Logistic回归分析显示,年龄,术前放宁、术后恢复时间、坐骨棘间径是LARS发生的危险因素(P<0.05)。多因素Logistic回归分析显示,术前放疗.术后恢复时间、坐骨棘间径是LARS发生的危险因素(P<0.05)。结论对于低位直肠癌行保肛手术治疗患者,术前放疗.术后恢复时间.坐骨棘间径与术后LARS的发生密切相关,对存在上述危险因素的低位直肠癌患者,术前应采取针对性预防措施,或采取其他术式治疗。

Objective To investigate the risk factors of low anterior resection syndrome(LARS)after sphincter preserving surgery for low rectal cancer.Methods A total o f 421 patients with low rectal cancer who underwent sphincter preserving surgery in Benxi Central Hospital from January 2015 to December 2019 were collected.The clinical data o f the patients were analyzed retrospectively.The patients were divided into LARS group(106 cases)and non LARS group(315 cases)according to the occurrence o f LARS.The risk factors o f LARS were analyzed.Results Univariate logistic regression analysis showed that age,preoperative radiotherapy,postoperative recovery time,ischial spine diam eter were risk factors for LARS(P<0.05).Multivariate logistic regression analysis showed that preoperative radiotherapy,postoperative recovery time and sciatic spine diam eter were risk factors for LARS(P<0.05).Conclusion For patients with low rectal cancer undergoing sphincter preserving surgery,preoperative radiotherapy,postoperative recovery time and ischial spine diam eter are closely related to LARS.For patients with low rectal cancer with the above risk factors,preventive m easures should be taken before operation,or other surgical methods should be used if possible.