直肠癌患者腹腔镜根治术后长期生存状况及相关影响因素分析

Analysis of Long-term Survival Status and Related Influencing Factors After Radical Laparoscopic Rectal Cancer

目的探究腹腔镜直肠癌患者根治术后长期生存状况及相关影响因素。方法70例直肠癌患者均行腹腔镜直肠癌根治术。术后行5年随访,5例失访,65例患者依据长期生存状况分为生存组(42例)及死亡组(23例)。分析影响腹腔镜直肠癌根治术后长期生存状况的相关因素。结果70例患者5年随访期间5例失访,剩余65例患者均完成随访;随访成功患者中生存42例,生存率为64.62%(42/65);死亡23例,死亡率为35.38%(23/65)。死亡组肿瘤分期Ⅲ期、溃疡型、伴淋巴结转移、术后并发症及腹腔镜Hartmann术发生率均高于生存组,差异有统计学意义(P<0.05);Logistic分析显示:肿瘤分期、病理分型、淋巴结转移、并发症、腹腔镜术式是影响腹腔镜直肠癌患者根治术后长期生存的独立危险因素(P<0.05)。结论直肠癌术后长期生存率较低,影响患者长期生存的包括肿瘤分期、病理分型、淋巴结转移、并发症、腹腔镜术式等因素,在临床干预中需予以重视。

Objective To investigate the long-term survival status and related influencing factors of patients after laparoscopic radical resection of rectal cancer.Methods 70 patients with rectal cancer underwent laparoscopic radical resection.Followed up for 5 years after operation,5 cases lost to follow-up,65 patients were divided into survival group(42 cases)and death group(23 cases)according to their long-term survival status.To analyze the factors related to long-term survival after laparoscopic radical resection of rectal cancer.Results Five of the 70 patients were lost during the 5-year follow-up period,and the remaining 65 patients were all followed up;42 of the successful patients survived,with a survival rate of 64.62%(42/65);23 cases died,the mortality was 35.38%(23/65).The incidence of tumor stage III,ulcer type,lymph node metastasis,postoperative complications and laparoscopic Hartmann operation in the death group were higher than those in the survival group(P<0.05);Logistic analysis showed that tumor stage,pathological classification,lymph node metastasis,complications,and laparoscopic surgery were independent risk factors for long-term survival after laparoscopic radical resection of rectal cancer(P<0.05).Conclusion The long-term survival rate of rectal cancer patients after operation is low.The factors that affect the long-term survival of patients include tumor stage,pathological classification,lymph node metastasis,complications,laparoscopic surgery and other factors,which should be paid attention to in clinical intervention.