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[结直肠癌切除术后吻合口漏的危险因素]

[Risk factors for anastomotic leakage following colorectal resection for cancer].

作者信息

Zaharie F, Mocan L, Tomuş C, Mocan T, Zaharie R, Bartoş D, Bartoş A, Vlad L, Iancu C

机构信息

Clinica Chirurgie III, Universitatea de Medicină si Farmacie "Iuliu Haţieganu", Cluj-Napoca, România.

出版信息

Chirurgia (Bucur). 2012 Jan-Feb;107(1):27-32.

Abstract

PURPOSE

To identify the risk and prognosis factors and their predictive value for anastomotic leakage after colorectal resections following cancer.

PATIENTS AND METHODS

1743 consecutive patients who underwent colic resections or rectal resections for colo-rectal cancer between 1996-2005 in Surgical Clinic no. 3 (Cluj-Napoca, Romania) were retrospectively analysed.

RESULTS

A total of 54 (3.09 percent) anastomotic leaks were confirmed. Univariate analisys showed that the preoperative variables significantly associated with anastomotic leakage included weight loss, smoking, cardiovascular disease, lung disease, hypoproteinemia, diabetes, anemia, leukocitosis, presence of two or more underlying diseases. Use of alcohol, cerebrovascular disease, bowel preparation, mode of antibiotic prophylaxis, type of handsewn anastomosis, tumor location, tumor stage and tumor histology were nonsignificant variables. Hipoproteniemia (S - proteins < 60g/dl) and anemia (S Hb < 11) remained significant in logistic regression model.

CONCLUSIONS

Our study shows that a value of S-proteins lower than 60 g/l and s-Hb lower than 99 g/l can be consider as predictive marker for anastomotik leak deshiscence.

摘要

目的

确定结直肠癌切除术后吻合口漏的风险、预后因素及其预测价值。

患者与方法

对1996年至2005年间在罗马尼亚克卢日-纳波卡市第3外科诊所因结直肠癌接受结肠切除术或直肠切除术的1743例连续患者进行回顾性分析。

结果

共证实54例(3.09%)发生吻合口漏。单因素分析显示,与吻合口漏显著相关的术前变量包括体重减轻、吸烟、心血管疾病、肺部疾病、低蛋白血症、糖尿病、贫血、白细胞增多、存在两种或更多基础疾病。饮酒、脑血管疾病、肠道准备、抗生素预防方式、手工缝合吻合方式、肿瘤位置、肿瘤分期和肿瘤组织学均为无显著意义的变量。在逻辑回归模型中,低蛋白血症(血清蛋白<60g/dl)和贫血(血清血红蛋白<11)仍具有显著意义。

结论

我们的研究表明,血清蛋白低于60g/l和血清血红蛋白低于99g/l的值可被视为吻合口漏裂开的预测指标。

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