直肠癌切除术后吻合口漏与患者长期预后的关系

目的：探讨吻合口漏与直肠癌术后局部复发和生存率的关系。方法：N对1978年-1996年行直肠癌前切除术的814例患者进行随访，并对发生与未发生吻合口漏患者的预后进行了单因素和多因素分析。结果：814例中89例（10.9%)发生了吻合口漏，经过Kaplan-Meier生存曲线分析，患者总体5a局部复发率是13.6%，多因素分析显示吻合口漏是影响吸瘤局部复发的独立危险因素（相对危险度为1.7,P=0.0418)，也是影响肿瘤相关生存率的独立危险因素（相对危险度为1.6,P=0.0172)。结论：吻合口漏是影响直肠癌患者术后局部复发率和肿瘤相关生存率的危险因素。

Long-term prognosis in patients with anastomotic leaks after anterior resection of rectal cancer

Objective:To explore the impact of anastomotic leakage on local recurrence and survival of patients after resection of rectal carcinoma.Methods:Eight hundred and forteen patients with anterior resection of rectal adenocarcinoma between 1978 and 1996 were enrolled into the study.The outcomes of the patients with or without anastomotic leakage were analyzed.Results:89 (10.9%) patients developed anastomotic leakage.The five year local recurrence (LR) rate by the Kaplan Meier method in the entire cohort was 13.6%.The multivariate analysis revealed anastomotic leakage as an independent significant risk factor for the LR (relative risk ratio=1.7, P =0.0418)and an independent prognostic factor for cancer related survival(relative risk ratio=1.6, P =0.0172).Conclusion:Anastomotic leakage was a prognostic factor for local tumour recurrence and cancer related survival of rectal cancer.