老年患者腹腔镜直肠癌根治术后发生吻合口漏相关因素的分析

Analysis of related factors of anastomotic leakage after laparoscopic radical resection of rectal cancer in elderly patients

目的探讨70岁以上老年患者行腹腔镜直肠癌根治术后发生吻合口漏相关因素.方法选择2017年2月-2022年2月在东海县人民医院治疗的年龄在70岁以上的老年直肠癌患者118例作为研究对象,采用腹腔镜下直肠癌根治术(DIXON)治疗.按照术后患者有无出现吻合口漏分组,总结引起患者术后发生吻合口漏的相关因素,并进行单因素和多因素分析.结果118例患者中,发生吻合口漏的占5.08%,根据单因素分析,男性、BMI>25kg/m^(2)、术前血清白蛋白<30g/L、手术时间≥3h、距肛缘距离≤5cm、术前接受新辅助化疗、患有糖尿病对患者发生术后吻合口漏有影响(P<0.05),多因素分析结果显示,患者性别、糖尿病、BMI、术前血清白蛋白水平、手术时间、距肛缘距离、行新辅助放化疗均为影响术后吻合口漏的独立危险因素.结论患者接受腹腔镜下直肠癌根治术治疗期间,多种因素均可诱发吻合口漏的发生,应针对性予以预防,保障手术质量,促进患者术后恢复.

Objective To study the related factors of anastomotic leakage in elderly patients over 70 years old after laparoscopic radical resection of rectal cancer.Methods A total of 118 elderly patients with rectal cancer over 70 years old who were treated in Donghai County People's Hospital from February 2017 to February 2022 were selected as the study objects,and underwent laparoscopic radical resection of rectal cancer(DIXON).The grouping was based on whether there was anastomotic leakage in postoperative patients,and the related factors causing the occurrence of postoperative anastomotic leakage were summarized,and univariate and multivariate analysis were carried out.Results There were 5.08%anastomotic leakage in 118 cases.According to single factor analysis,men,BMI>25kg/m^(2),preoperative serum albumin<30g/L,surgical time≥3h,distance from anal margin≤5cm,preoperative neoadjuvant chemotherapy,and diabetes have an impact on postoperative anastomotic leakage in patients(P<0.05).The results of multivariate analysis showed that,Patient gender,diabetes,BMI,preoperative serum albumin level,operation time,distance from anal margin,neoadjuvant chemoradiotherapy were all independent risk factors for postoperative anastomotic leakage.Conclusion During laparoscopic radical resection of rectal cancer,anastomotic leakage can be induced by various factors,which should be targeted to prevent,ensure the quality of surgery,and promote postoperative recovery of patients.