直肠前切除术后吻合口狭窄影响因素分析

目的 探讨直肠前切除术后发生吻合口狭窄的影响因素。方法 回顾性分析2012年1月至2017年12月间就诊于中国医科大学附属盛京医院结直肠肿瘤外科收治并行直肠前切除术的760例直肠恶性肿瘤病人的临床资料，采用Logistic回归分析发生吻合口狭窄的原因。 结果 111例（14.6%）病人发生吻合口狭窄。单因素分析中，性别（χ2=6.978，P=0.008）、术中保护性造口（χ2=4.015，P=0.045）、肿瘤下缘与肛缘距离（t=3.239，P=0.001）和术后是否发生吻合口漏（χ2=9.721，P=0.002）差异有统计学意义。Logistic回归分析显示，性别（OR=1.776，95%CI 1.128~2.796，P=0.013）、肿瘤下缘与肛缘距离（OR=0.907，95%CI 0.855~0.961，P=0.001）和术后发生吻合口漏（OR=2.255，95%CI 1.293~3.932，P=0.004）为发生吻合口狭窄的独立影响因素。结论 性别为男性、肿瘤下缘与肛缘距离较近及术后发生吻合口漏的病人更易发生吻合口狭窄。

A multivariate analysis of anastomotic stricture after anterior resection operation on rectal cancer

A multivariate analysis of anastomotic stricture after anterior resection operation on rectal cancer FAN Si-rao，ZHANG Hong，LIU Ding-sheng，et al. Department of Colorectal Tumor Surgery，Shengjing Hospital Affiliated to China Medical University，Shenyang 110004，China
Corresponding author：ZHANG Hong，E-mail：haojiubujian1203@sina.cn
Abstract Objective To investigate influential factors of anastomotic stricture after anterior resection operation on rectal cancer. Methods The clinicopathologic data of 760 patients who visit and underwent surgical operation between January 2012 and December 2017 in Department of Colorectal Tumor Surgery，Shengjing Hospital Affiliated to China Medical University were analyzed retrospectively. The causes of anastomotic stricture were investigated with logistic regression. Results A total of 111 patients suffered anastomotic stricture (14.6%). Univariate analysis showed that sexual distinction (χ2=6.978，P=0.008)，temporarily ileostomy in surgery (χ2=4.015，P=0.045)，distance from anal verge (t=3.239，P=0.001) and anastomotic leak after surgery (χ2=9.721，P=0.002) were relation to anastomotic stricture. Multivariate factors showed sexual distinction (OR=1.776，95%CI 1.128-2.796，P=0.013)，distance from anal verge (OR=0.907，95%CI 0.855-0.961，P=0.001) and anastomotic leak after surgery (OR=2.255，95%CI 1.293-3.932，P=0.004) were independent factors of anastomotic stricture. Conclusion Patients who is the male，approach anal verge and patients who had anastomotic leak after surgery likely develop anastomotic stricture.