腹腔镜直肠前切除术后并发症及其相关因素分析

摘要

目的 分析腹腔镜直肠前切除术后并发症发生率及其相关危险因素,进一步预防术后并发症的发生.方法 回顾性分析解放军总医院普通外科2013年1月至2016年6月间施行腹腔镜直肠前切除术的663例病人的临床资料,观察术后并发症发生情况,对发生术后并发症的危险因素进行分析,分析并发症组与无并发症组临床资料的差异性.结果 全组663例病人出现并发症76例(11.5％);单因素分析显示:病人的性别、肥胖、术前合并症、肿瘤位置、淋巴结清扫数目、TNM分期、手术时间与腹腔镜直肠前切除术后并发症相关(P＜0.05).多因素回归分析显示:性别(OR=2.120,95％CI:1.150～3.909)、术前合并症(OR=2.618,95％CI:1.483～4.621)、肿瘤位置(OR=10.338,95％CI:5.672～18.842)、TNM分期(OR=3.111,95％CI:1.774～5.457)是影响术后并发症发生的独立危险因素(均P＜0.05).结论 性别、术前合并症、肿瘤位置、TNM分期是腹腔镜直肠前切除术后并发症发生的危险因素,腹腔镜直肠前切除术后并发症以吻合口瘘常见.%Objective To investigate the related factors of postoperative complications in patients with laparoscopic anterior resection of rectal cancer and to prevent postoperative complications.Methods From January 2013 to June 2016,663 patients with rectal cancer undergoing laparoscopic anterior resection of rectal cancer in the Department of General Surgery of PLA General Hospital were included.Postoperative complications and potential risk factors were analyzed.Results Seventy-six patients (11.5％) in all 663 patients developed complications and univariate analysis showed that sex,obesity,preoperative complications,tumors,TNM staging and operation time were associated with complications after laparoscopic anterior resection (P＜0.05).Multiple regression analysis showed that gender,preoperative complications,tumors and TNM staging were independent risk factors for postoperative complications (P＜0.05).Conclusions Sex,complications,preoperative comorbidity,tumor site and TNM staging are risk factors of postoperative complications and anastomotic fistula is the most common complication after laparoscopic anterior resection.