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[结直肠癌择期切除术后的发病率和死亡率]

[Morbidity and mortality after elective resections of colorectal cancers].

作者信息

Böhm B, Nouchirvani K, Hucke H P, Stock W

机构信息

Chirurgische Abteilung, Marien-Hospitals, Düsseldorf, Bundesrepublik Deutschland.

出版信息

Langenbecks Arch Chir. 1991;376(2):93-101. doi: 10.1007/BF01263466.

Abstract

There are few actual published results about morbidity and mortality after elective resection of colorectal cancer. Out of 596 patients with colorectal cancer, the medical records of 492 who had been prepared preoperatively according to our predefined standards and electively operated on, were analysed. We studied the results of morbidity and mortality and their association with preexisting conditions and preoperative complications. We found that 50% of our patients had preexisting conditions and that 18.7% had preoperative complications (obstruction, ileus, infections). The rate of general postoperative complications was 30.5%. While for pneumonia (13%) there was age and sex relation, for urinary infection (12.7%) there was only sex relation. We were able to reduce urinary infections by half (5.7%), by using a suprapubic catheter. 11.4% of our patients had local complications (anastomotic leakage 2%, ileus 2.2%, bleeding 1.6%, fistula 1.2%). These were neither dependent on age or sex, nor on preoperative complications or preexisting conditions. Mortality within 30 days was 2% and overall mortality was 2.6%. Our results show that careful diagnosis and treatment of preexisting conditions, bowel preparation and an improvement in operating techniques can all lead to improved results after elective resection.

摘要

关于择期结直肠癌切除术后的发病率和死亡率,实际发表的结果很少。在596例结直肠癌患者中,分析了492例术前按照我们预先定义的标准进行准备并接受择期手术的患者的病历。我们研究了发病率和死亡率的结果及其与既有疾病和术前并发症的关系。我们发现,50%的患者有既有疾病,18.7%的患者有术前并发症(梗阻、肠梗阻、感染)。术后总体并发症发生率为30.5%。虽然肺炎(13%)存在年龄和性别相关性,但尿路感染(12.7%)仅存在性别相关性。通过使用耻骨上导管,我们能够将尿路感染率降低一半(5.7%)。11.4%的患者有局部并发症(吻合口漏2%、肠梗阻2.2%、出血1.6%、瘘管1.2%)。这些并发症既不依赖于年龄或性别,也不依赖于术前并发症或既有疾病。30天内的死亡率为2%,总体死亡率为2.6%。我们的结果表明,对既有疾病进行仔细的诊断和治疗、肠道准备以及手术技术的改进都可以使择期切除术后的结果得到改善。

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