胃癌术后腹腔淋巴瘘的相关因素分析

Related Factors Analysis of Lymphatic Fistulas in Postoperative Patients with Gastric Carcinoma

目的:探讨胃癌术后腹腔淋巴瘘的相关因素。方法:回顾分析26例胃癌术后腹腔淋巴瘘(LF)与肿瘤分期、肿瘤部位、术式、淋巴结转移、早期肠内营养(EN)及肝硬化间关系。结果:术后LF发生率为7.60%,早期肠内营养组高于非肠内营养组(14.29%比3.70%,P<0.01);pTNMⅡ、Ⅲ期高于Ⅰ、Ⅳ期,Ⅲ期高于Ⅱ期(11.95%比7.94%,P<0.05);D2以上术高于D2术(11.05%比4.23%,P<0.01);胃中、上部癌高于下部癌(11.80%比3.05%,P<0.01);淋巴结转移组高于未转移组(9.59%比4.07%,P<0.05);是否合并肝硬化两组无显著差异(8.09%比6.54%,P>0.05)。结论:D2及D2以上术式、pTNMⅡ、Ⅲ期、中上部癌、淋巴结转移、术后早期EN是胃癌术后LF的危险因素。

Objective: To analyze the related factors of lymphatic fistulas (LF) of postoperative patients with gastric carcinoma. Methods: The relationship of LF and tumour stage and tumour site and surgical style and lymphatic metastasis and early enteral nutrition and cirrhosis of liver was analyzed retrospectively. Results: The mean incidence rate of postoperative LF is 7.6%. The rate of early enteral nutrition group is higher than that of non-enteral nutrition group (14.29% vs 3.70%, P<0.01). The rate of pTNM Ⅱand Ⅲ stage group is higher than that of pTNM Ⅰand Ⅳstage group, and the rate of pTNM Ⅲ group is higher than that of pTNMⅡgroup(11.95% vs 7.94%, P<0.05). The rate of surgical group beyond D2 style is higher than that of surgical group with D2 style (11.05% vs 4.23%, P<0.01). The rate of group of middle-superior carcinoma of stomach is higher than that of inferior group (11.80% vs 3.05%, P<0.01). The rate of group with lymphatic metastasis is higher than that of group with non-lymphatic metastasis(9.59% vs 4.07%, P<0.05). However, the difference between the group with cirrhosis of liver and that with non-cirrhosis of liver is no statistical significance (8.09% vs 6.54%). Conclusion: Risk factors of LF of postoperative patients with gastric carcinoma include surgical style D2 or beyond D2, pTNM Ⅲ stage, middle-superior carcinoma of stomach, lymphatic metastasis and postoperative early enteral nutrition.