直肠前切除术后吻合口漏的危险因素分析

目的 随着全直肠系膜切除的广泛应用,直肠癌的远期疗效得到极大的改善,然而直肠癌术后吻合口漏的发生率却没有明显的降低,本研究旨在探讨直肠癌术后吻合口漏的危险因素.方法 采用回顾性病例对照研究分析蚌埠医学院第一附属医院胃肠外科2017年1月-2019年12月行直肠前切除的395例患者的临床病理资料,根据术后有无发生吻合口漏...

Analysis on risk factors of anastomotic leakage after anterior resection for rectal cancer

  Objective  With the application of total mesorectal excision (TME), the long-term effect of rectal cancer has been greatly improved. However, the incidence of postoperative anastomotic leakage of rectal cancer is not significantly reduced, so it is very important to explore the risk factors of postoperative anastomotic leakage of rectal cancer.  Methods  A retrospective case-control study was conducted to analyze the cases of anterior resection for rectal cancer in Department of Gastrointestinal Surgery, of the First Affiliated Hospital of Bengbu Medical College from January 2017 to December 2019. According to the occurrence of anastomotic leakage, the patients were divided into anastomotic leakage group (38 cases) and non-anastomotic leakage group (395 cases). Univariate and multivariate analysis were carried out to explore the risk factors of anastomotic leakage.  Results  Anastomotic leakage occurred in 38 patients (9.62%) of 395 patients with rectal cancer who underwent anterior resection. Chi-square test showed that gender (P=0.005) and the number of distal rectal cut closure (P=0.031) were significantly associated with anastomotic leakage. Multivariate logistic regression analysis revealed that male (OR=3.145, 95% CI: 1.344-7.356, P=0.008) and more than 2 staples of distal rectal cut closure (OR=2.083, 95% CI: 1.026-4.229, P=0.042) were independent risk factors for anastomotic leakage.  Conclusion  The incidence of anastomotic leakage in patients undergoing anterior resection is 9.62%. The high risk factors for anastomotic leakage are male and more than 2 staples of distal rectal cut closure. In order to reduce the occurrence of anastomotic leakage, it is helpful to reduce use frequency of staples of distal rectal cut closure.