Ⅱ型贲门腺癌术后早期并发症的多因素分析

目的 筛选和确定Ⅱ型贲门腺癌患者发生术后早期并发症的危险因素.方法 回顾分析1998年1月至2007年12月期间行手术治疗的61例Ⅱ型贲门腺癌患者的临床资料,分析早期并发症的发生情况及相关影响因素.结果 总的并发症发生率为31.1%(19/61),其中吻合口瘘发生率为6.6%(4/61),肺部并发症为14.8%(9/61),影响术后吻合口瘘的危险因素为口侧切除长度(P=0.0329)和淋巴结清扫等级(P=0.0156).影响术后肺部并发症的危险因素亦为口侧切除长度(P=0.0299)和淋巴结清扫等级(P=0.0411).并发症发生率与术后住院时间有关(P=0.0005).吻合口瘘和肺部并发症发生有关联(P=0.0086).结论 随着口侧切除长度的增加和淋巴结清扫等级的提升,吻合口瘘和肺部并发症的发生率也相应增多,应提高手术和术后管理的技巧,减少术后并发症的发生.

Multivariate analysis of early postoperative complications in type Ⅱ cardia adenocarcinoma

Objective To screen and identify main risk factors of early complications after operation for type Ⅱ cardia adenocarcinoma. Methods From Jan 1998 to Dec 2007, the data of 61 patients with type Ⅱ cardia adenocarcinoma who received operation were analyzed retrospectively. Early complications and the related factors were observed and analyzed. Results Overall complications rate was 31.1% ( 19/61 ). Anastomotic leakage rate was 6.6% (4/61). Pulmonary complication rate was 14.8%(9/61 ). Predictive factors of both anastomotic leakage and pulmonary complications were length of oral margin (P= 0.0329 and P=0.0299, respectively) and lymphnodes dissection (P=0.0156 and P=0.0411, respectively). The significant relationship between complications and postoperative hospital stay was found (P=0.0005). Anastomotic leakage was associated with pulmonary complications (P=0.0086). Conclusions With the increase of oral margin length and lymphnodes dissection, the rates of anastomotic leakage and pulmonary complications are elevated correspondingly. Advanced surgical skills and postoperative management need to be improved postoperative complications.