低位前切除术后行临时造口的直肠癌患者永久性造口的危险因素
Risk factors of permanent stomas in patients with rectal cancer after low anterior resection with temporary stomas.
作者信息
Lee Chul Min, Huh Jung Wook, Park Yoon Ah, Cho Yong Beom, Kim Hee Cheol, Yun Seong Hyeon, Lee Woo Yong, Chun Ho-Kyung
机构信息
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
出版信息
Yonsei Med J. 2015 Mar;56(2):447-53. doi: 10.3349/ymj.2015.56.2.447.
PURPOSE
The aim of this study was to identify risk factors influencing permanent stomas after low anterior resection with temporary stomas for rectal cancer.
MATERIALS AND METHODS
A total of 2528 consecutive rectal cancer patients who had undergone low anterior resection were retrospectively reviewed. Risk factors for permanent stomas were evaluated among these patients.
RESULTS
Among 2528 cases of rectal cancer, a total of 231 patients had a temporary diverting stoma. Among these cases, 217 (93.9%) received a stoma reversal. The median period between primary surgery and stoma reversal was 7.5 months. The temporary and permanent stoma groups consisted of 203 and 28 patients, respectively. Multivariate analysis showed that independent risk factors for permanent stomas were anastomotic-related complications (p=0.001) and local recurrence (p=0.001). The 5-year overall survival for the temporary and permanent stoma groups were 87.0% and 70.5%, respectively (p<0.001).
CONCLUSION
Rectal cancer patients who have temporary stomas after low anterior resection with local recurrence and anastomotic-related complications may be at increased risk for permanent stoma.
目的
本研究旨在确定影响直肠癌低位前切除术后带临时造口患者永久性造口的危险因素。
材料与方法
对连续2528例行低位前切除术的直肠癌患者进行回顾性分析。评估这些患者发生永久性造口的危险因素。
结果
在2528例直肠癌患者中，共有231例患者行临时转流造口。其中，217例（93.9%）进行了造口还纳。初次手术至造口还纳的中位时间为7.5个月。临时造口组和永久性造口组分别有203例和28例患者。多因素分析显示，永久性造口的独立危险因素为吻合口相关并发症（p = 0.001）和局部复发（p = 0.001）。临时造口组和永久性造口组的5年总生存率分别为87.0%和70.5%（p < 0.001）。
结论
低位前切除术后有临时造口且出现局部复发和吻合口相关并发症的直肠癌患者发生永久性造口的风险可能增加。
Zotero 插件