进展期远端胃癌患者腹腔镜根治术后吻合口狭窄发生的影响因素

目的分析进展期远端胃癌(GC)患者腹腔镜根治术后吻合口狭窄发生的影响因素。方法选取行腹腔镜根治术后发生吻合口狭窄的47例进展期远端GC患者,纳为发生组;另选取同期腹腔镜根治术后未发生吻合口狭窄的47例进展期远端GC患者,纳为未发生组。全部患者病历资料、实验室相关检查资料等均完整;设计基线资料填写表,阅读患者基线资料并记录研究所需资料,将可能的影响因素纳入,经单因素、多因素分析找出可能导致进展期远端GC患者腹腔镜根治术后发生吻合口狭窄的影响因素。结果初步比较发生、未发生吻合口狭窄进展期远端GC患者相关基线资料,后经Logistic回归分析结果显示,多层吻合、吻合口水肿、白细胞介素6(IL-6)与肿瘤坏死因子α(TNF-α)过表达均可能是进展期远端GC患者腹腔镜根治术后吻合口狭窄发生的影响因素(OR>1,P<0.05)。结论进展期远端GC患者腹腔镜根治术后吻合口狭窄发生可能与患者多层吻合、吻合口水肿、IL-6与TNF-α过表达有关,临床可据此提出针对性干预方案。

Influencing Factors of Anastomotic Stenosis in Patients with Advanced Distal Gastric Cancer After Laparoscopic Radical Resection

Objective To analyze the influencing factors of anastomotic stenosis in patients with advanced distal gastric cancer(GC) after laparoscopic radical resection.Methods 47 patients with advanced distal GC who had anastomotic stenosis after laparoscopic radical resection were the occurrence group;and 47 patients with advanced distal GC who had no anastomotic stenosis after laparoscopic radical resection were the non occurrence group.The medical records of all patients and laboratory related examination data were complete;designed the baseline data filling form, read the baseline data of the patients and recorded the data required for the study, the possible influencing factors were included, univariate and multivariate analysis were used to find out the influencing factors that might lead to anastomotic stenosis in patients with advanced distal GC after laparoscopic radical resection.Results The baseline data of advanced distal GC patients with and without anastomotic stenosis were preliminary compared, after Logistic regression analysis, the results showed that multilayer anastomosis, anastomotic edema, the overexpression of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) all might be the influencing factors of anastomotic stenosis in patients with advanced distal GC after laparoscopic radical resection(OR>1,P<0.05).Conclusion The anastomotic stenosis in patients with advanced distal GC after laparoscopic radical resection may be related to multilayer anastomosis, anastomotic edema and overexpression of IL-6 and TNF-α,targeted intervention programs can be put forward in clinic according to this.