腹腔镜辅助远端胃癌根治术手术时间延长的相关因素分析及对术后并发症的影响

摘要

目的:探讨腹腔镜辅助远端胃切除术(laparoscopic assisted distal gastrectomy ,LADG)治疗胃癌手术时间延长的相关危险因素及对术后并发症的影响.方法:选取2010年1月至2015年6月收治的168例行LADG的患者.中位手术时间为210 min,手术时间≥210 min定义为长时间组(n＝74),＜210 min定义为短时间组(n＝94).分析影响手术时间的相关因素,并比较两组术后并发症.结果:单因素分析结果显示手术时间延长与体质量指数、淋巴结转移、肿瘤分化程度、消化道重建方式有关(P＜0.05).多因素分析结果显示,BMI≥25 kg／m2是LADG手术时间延长的独立危险因素(P＜0.05). 22例患者术后发生并发症,发生率为13.10%.长时间组术后总并发症发生率明显高于短时间组(P＜0.05).结论:LADG手术时间的延长与患者BMI密切相关,同时手术时间延长会增加术后总并发症发生率.%Objective:To explore the impact factors of operation time prolongation of laparoscopic assisted distal gastrectomy (LADG) for gastric cancer and its effect on postoperative complications.Methods:The data of 168 patients who underwent LADG from Jan.2010 to Jun.2015 were retrospectively analyzed.The median operation time was 210 min.74 patients with operation time ≥210 min and 94 patients with operation time ＜210 min were allocated into the long time group and short time group.Impact factors of opera－tion time of LADG were analyzed and the incidences of postoperative complications were compared between the two groups .Results:The body mass index,differentiation of carcinoma and reconstruction techniques were factors affecting longer operation time of LADG by the univariate analysis (P＜0.05).Multifactor analysis revealed that BMI ≥25 kg／m2was independent risk factors (P＜0.05).Postopera－tive complications occurred in 22 patients and the incidence was 13.10%.The incidence of postoperative complications in the long time group was significantly higher than that in the short time group (P＜0.05).Conclusions:Longer operation time of LADG is closely as－sociated with BMI,and increases the incidence of postoperative complications.