腹腔镜直肠癌根治术后低位前切除综合征发生风险分析

Risk analysis of low anterior resection syndrome after laparoscopic radical resection of rectal cancer

目的分析腹腔镜直肠癌根治术后低位前切除综合征(LARS)发生风险。方法选取安徽省黄山市人民医院2017年6月至2020年1月行腹腔镜直肠癌根治术并完成术后随访24个月的80例直肠癌患者为研究对象。根据术后患者是否发生LARS将其分为LARS组和非LARS组。收集患者临床资料,分析可能影响腹腔镜直肠癌根治术后患者发生LARS的相关因素,采用logistic回归分析法明确危险因素。结果80例患者随访24个月,发生LARS患者49例(61.25%)为LARS组,未发生LARS患者有31例(38.75%)为非LARS组。单因素分析显示,LARS组吻合口距肛门距离较非LARS组更短(P<0.05),LARS组体重指数(BMI)>25 kg/cm^(2)占比较非LARS组更高(P<0.05)。logistic回归分析显示,BMI>25 kg/cm^(2)(OR=2.385,95%CI:1.875,2.895)、吻合口距肛门距离(OR=0.321,95%CI:-0.381,1.023)均是行腹腔镜直肠癌根治术的直肠癌患者发生LARS的影响因素(P<0.05)。结论BMI与吻合口距肛门距离均是直肠癌患者术后LARS的影响因素,LARS发生风险较高。识别危险因素,有助于临床选择科学手术方式,降低LARS发生率。

Objective To analyze the risk of low anterior resection syndrome(LARS)after laparoscopic radical resection of rectal cancer.Methods A total of 80 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer in Huangshan People’s Hospital Anhui Province from June 2017 to January 2020 and were followed up for 24 months were selected as the study subjects.Patients were divided into LARS group and non-LARS group according to whether or not occurred LARS after surgery.Clinical data of patients were collected to analyze the related factors that may affect the occurrence of LARS in patients after laparoscopic radical resection of rectal cancer,and the risk factors were identified by logistic regression analysis.Results A total of 80 patients followed up for 24 months,49(61.25%)of the patients with LARS were the LARS group,and 31(38.75%)of the patients without LARS were the non-LARS group.Univariate analysis showed that the anastomotic distance from stamo to anus in the LARS group was shorter than the non-LARS group(P<0.05),and the proportion of body mass index(BMI)>25 kg/cm^(2) in the LARS group was higher than that in the non-LARS group(P<0.05).Logistic regression analysis showed that BMI>25 kg/cm^(2)(OR=2.385,95%CI:1.875,2.895),anastomotic distance from the anus(OR=0.321,95%CI:-0.381,1.023)were risk factors for LARS in rectal cancer patients undergoing laparoscopic radical resection for rectal cancer(P<0.05).Conclusion BMI and the anastomotic distance from stoma to anus are important influencing factors for LARS in patients with rectal cancer after operation,and the risk of LARS is high.Identifying risk factors is helpful for clinical selection of scientific surgical methods and reduction of LARS incidence.