确定吻合口漏的独立预测因素：682 例肠吻合术分析。

Determination of independent predictive factors for anastomotic leak: analysis of 682 intestinal anastomoses.

机构信息

Academic Department of Surgery, Division of General Surgery, Greenville Memorial Hospital, University of South Carolina School of Medicine-Greenville, 3rd Floor, 701 Grove Road, Greenville, SC 29605, USA.

出版信息

Am J Surg. 2013 Dec;206(6):950-5; discussion 955-6. doi: 10.1016/j.amjsurg.2013.07.017. Epub 2013 Sep 24.

DOI:10.1016/j.amjsurg.2013.07.017

PMID:24070663

Abstract

BACKGROUND

The objective of this study was to identify risk factors associated with intestinal anastomotic leakage in order to practically assist in surgical decision making.

METHODS

A retrospective review of an academic surgery database was performed over 5 years to identify patients who had intestinal (small bowel and colon) anastomoses to determine independent predictors of anastomotic leakage.

RESULTS

Over the study period, 682 patients were identified with intestinal anastomoses; the overall leak rate was 5.6% (38/682). In bivariate analysis, 9 factors were associated with anastomotic leaks. Of these, 3 were found to be independent predictors of anastomotic leakage using a logistic regression model: anastomotic tension (odds ratio [OR] = 10.1, 95% Confidence Interval [CI] 1.3 to 76.9), use of drains (OR = 8.9, 95% CI 4.3 to 18.4), and perioperative blood transfusion (OR = 4.2, 95% CI 1.4 to 12.3).

CONCLUSIONS

The recognition of factors associated with anastomotic leakage after intestinal operations can assist surgeons in mitigating these risks in the perioperative period and guide intraoperative decisions.

摘要

背景

本研究旨在确定与肠吻合口漏相关的风险因素，以便在实践中协助外科决策。

方法

对 5 年内的一个学术手术数据库进行回顾性分析，以确定进行肠（小肠和结肠）吻合术的患者，从而确定吻合口漏的独立预测因素。

结果

在研究期间，共确定了 682 例有肠吻合术的患者；总的吻合口漏发生率为 5.6%（38/682）。在单变量分析中，有 9 个因素与吻合口漏有关。其中，有 3 个因素通过逻辑回归模型被确定为吻合口漏的独立预测因素：吻合口张力（比值比 [OR] = 10.1，95%置信区间 [CI] 1.3 至 76.9）、引流管的使用（OR = 8.9，95% CI 4.3 至 18.4）和围手术期输血（OR = 4.2，95% CI 1.4 至 12.3）。