Motycka P, Dolezal B, Ferko A, Subrt Z
Chirurgická klinika LF UK v Hradci Králové a FN Hradec Králové.
Rozhl Chir. 2007 Jan;86(1):17-23.
Anastomotic insufficiency is the primary cause of postoperative morbidity and mortality following resection procedures of the large intestine and rectum.
In the retrostpective study, the authors analysed rates of rectal and sigmoideal anastomotic insufficiencies in patients operated for rectal and sigmoideal carcinomas in the Faculty Hospital Surgical Clinic in Hradec Králové from 2000 to 2004. At the same time, the authors analysed risk factors of the insufficiencies. The subject of protective derivation stomies is discussed.
In the group with primary colorectal anastomosis, the anastomotic insufficiency occured in 11% of the group subjects, in the group with primary sigmoideal anastomosis in 9.1% of the group subjects. Out of the total of 215 subjects, the anastomotic insufficiency occurred in 23 subjects (10.7 %), 6 cases were fatal and the overall postoperative mortality was 1.56 % . In the anastomotic insufficiency group, it reached 13.04 %. The difference between the studied groups is significant (p<0,001, OR = 10.5).
Postoperative mortality in sigmoideal and rectal resection procedures correlates with anastomotic insufficiency.
吻合口漏是大肠和直肠切除术后发病和死亡的主要原因。
在这项回顾性研究中,作者分析了2000年至2004年在赫拉德茨克拉洛韦市大学医院外科诊所接受直肠癌和乙状结肠癌手术患者的直肠和乙状结肠吻合口漏发生率。同时,作者分析了吻合口漏的危险因素。讨论了保护性转流造口的问题。
在一期结直肠吻合组中,吻合口漏发生率为该组患者的11%,在一期乙状结肠吻合组中为该组患者的9.1%。在总共215例患者中,23例(10.7%)发生了吻合口漏,6例死亡,总体术后死亡率为1.56%。在吻合口漏组中,死亡率达到13.04%。研究组之间的差异具有统计学意义(p<0.001,OR=10.5)。
乙状结肠和直肠切除术后的死亡率与吻合口漏相关。