Yamamoto Seiichiro, Fujita Shin, Akasu Takayuki, Inada Ryo, Moriya Yoshihiro, Yamamoto Seiichiro
Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Surg Laparosc Endosc Percutan Tech. 2012 Jun;22(3):239-43. doi: 10.1097/SLE.0b013e31824fbb56.
This study evaluated the risk factors for anastomotic leakage after laparoscopic surgery for rectal cancer using a stapling technique.
The total prospective registry of 111 patients with rectal cancer who initially underwent laparoscopic low anterior resection using a stapling technique was reviewed. Univariate and multivariate analyses were carried out to identify relevant risk factors.
Overall anastomotic leakage rate was 5.4% (6/111). Univariate analysis demonstrated that body mass index (BMI) (P=0.0377) was significantly associated with anastomotic leakage. After univariate analysis, the variables of BMI and the size of the circular stapler (P=0.0923) were selected for multivariate analysis, as their P values were <0.2, and multivariate analysis demonstrated that BMI was independently predictive of developing anastomotic leakage (P=0.0458).
Laparoscopic surgery for rectal cancer using a stapling technique can be performed safely without increasing the risk of anastomotic leakage, and increased BMI might be a potential risk factor for anastomotic leakage.
本研究评估了使用吻合器技术的腹腔镜直肠癌手术后吻合口漏的危险因素。
回顾了111例最初接受使用吻合器技术的腹腔镜低位前切除术的直肠癌患者的前瞻性总登记资料。进行单因素和多因素分析以确定相关危险因素。
总体吻合口漏发生率为5.4%(6/111)。单因素分析表明,体重指数(BMI)(P=0.0377)与吻合口漏显著相关。单因素分析后,选择BMI和圆形吻合器尺寸变量(P=0.0923)进行多因素分析,因为它们的P值<0.2,多因素分析表明BMI是吻合口漏发生的独立预测因素(P=0.0458)。
使用吻合器技术的腹腔镜直肠癌手术可安全进行,且不会增加吻合口漏的风险,BMI升高可能是吻合口漏的潜在危险因素。