直肠癌AR术后吻合口漏发生特点及其相关因素分析

Occurrence characteristics and regression analysis of anastomotic leakage after anterior resection of rectal cancer

目的:探究直肠癌AR术后吻合口漏发生特点及其相关因素。方法:采集240例直肠癌行AR术治疗的患者资料,分为吻合口漏组与非吻合口漏组,分析吻合口漏发生相关因素。结果:单因素分析显示:吻合口漏组年龄≥60岁、合并糖尿病、手术方式为腹腔镜手术、手术时间>180 min、使用直线切割器数目≥3个、未行预防性造口、手工吻合占比高于非吻合口漏组(P<0.05);多因素分析显示:高龄、合并糖尿病、使用直线切割器数目较多、手工吻合均为直肠癌AR术后发生吻合口漏的影响因素(P<0.05)。结论:直肠癌AR术后吻合口漏发生风险高,高龄、糖尿病、吻合口距肛缘距离短均为其危险因素。

Objective:To investigate the characteristics of the occurrence of anastomotic leakage after AR for rectal cancer and its associated factors.Methods:The data of 240 patients treated with AR for rectal cancer were collected and divided into anastomotic leak group and non-anastomotic leak group to analyse the factors associated with the occurrence of anastomotic leak.Results:Univariate analysis showed that age≥60 years,combined diabetes,laparoscopic surgery,operative time>180 min,number of linear cutters used≥3,no prophylactic stoma,and manual anastomosis accounted for a higher proportion in the anastomotic leak group than in the non-anastomotic leak group(P<0.05);multivariate analysis showed that advanced age,combined diabetes,higher number of linear cutters used,and manual anastomosis were all factors influencing the occurrence of anastomotic leak after AR for rectal cancer(P<0.05).Conclusion:The risk of anastomotic leak after AR for rectal cancer is high,with advanced age,diabetes and short distance of the anastomosis from the anal verge all being risk factors.