结直肠癌手术死亡相关因素分析

目的:研究旨在探讨结直肠癌手术死亡相关的临床病理影响因素.方法:回顾中山大学肿瘤防治中心1964年1月至2004年12月经手术治疗的4498例结直肠癌患者的临床病理资料,应用单因素和多因素Logistic回归分析手术死亡的相关影响因素.结果:全组手术死亡者共62例,手术死亡率为1.38%,主要死亡原因为多器官功能衰竭、中毒性休克、心血管疾病、急性肾功能衰竭、吻合口漏等.单因素分析显示,性别、术前基础疾病、术前合并症、腹水、手术年代、手术性质、Dukes分期、术后并发症等为影响手术死亡的因素,而年龄、肿瘤部位、组织类型、病理分级与手术死亡无关.多因素分析表明,术前基础疾病、术前合并症、腹水、手术年代、手术性质、Dukes分期、术后并发症是结直肠癌手术死亡的独立影响因素.结论:术前基础疾病、术前合并症、腹水、手术年代、手术性质、Dukes分期、术后并发症是结直肠癌手术死亡的独立影响因素.

Multivariate analysis of predictive factors for postoperative death in patients with colorectal cancer

Objective: This study was to investigate risk factors for postoperative death in patients with colorectal cancer. Methods: A total of 4498 patients with colorectal cancer who received surgical treatment at Cancer Center, Sun Yat-sen University from 1964 to 2004 were reviewed. Causes of postoperative death was analysed and correlations of 12 clinicopathologic factors of these patients to postoperative death were studied with univariate and multivariate regression analysis. Results: Sixty-two patients died within 30 days after operation, with an overall postoperative mortality of 1.38%. Main death causes included multiple organ failure, toxic shock, cardiovascular diseases, acute renal failure and anastomotic leakage, et al. Univariate analysis showed sex, preoperative comorbidity, preoperative complication, ascites, the year of operation, type of resection, Dukes stage and postoperative complication were correlated to postoperative death, while multivariate analysis revealed those factors above were all independent factors except for sex. Conclusion: Preoperative comorbidity, preoperative complication, ascites, the year of operation, type of resection, Dukes stage and postoperative complication are independent predictive factors for postoperative death in patients with colorectal cancer.