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结直肠肿瘤手术后吻合口位置不同对吻合口漏的预测因素的影响。

DIFFERENCE IN PREDICTORS OF ANASTOMOTIC LEAKAGE DEPENDING ON THE LEVEL OF ANASTOMOSIS AFTER COLORECTAL CANCER SURGERY.

机构信息

Department of General Surgery, Zemun University Hospital, Belgrade, Serbia.

出版信息

Acta Clin Croat. 2022 Feb;60(3):341-346. doi: 10.20471/acc.2021.60.03.01.

Abstract

Anastomotic leak (AL) after colorectal cancer surgery is one of the most serious postoperative complications which has major impact on outcomes. The aim of this study was to investigate preoperative and intraoperative risk factors for AL, as well as to examine whether there are differences in risk factors for AL depending on the primary tumor location. We retrospectively reviewed records of patients having undergone colorectal surgical procedures for malignancies between January 2013 and December 2017 in a single institution. Only procedures with primary anastomosis were included. Of the 153 patients, AL occurred in 10.6% of patients with primary tumor in the sigmoid colon and rectum, and in 8.2% of patients with primary tumor in the proximal sections of the colon. On univariate analysis, delayed oral intake and more advanced histologic stages of the tumor were significantly correlated with AL in patients with tumors in the sigmoid colon and rectum, and multiorgan resection and distant metastases in patients with tumors in the proximal sections of the colon. In conclusion, risk factors for the occurrence of AL vary depending on the primary tumor location and further investigation is needed to provide better insight into these differences.

摘要

结直肠肿瘤术后吻合口漏是最严重的术后并发症之一,对患者的预后有重大影响。本研究旨在探讨吻合口漏的术前和术中危险因素,并分析吻合口漏的危险因素是否因原发肿瘤位置而异。我们回顾性分析了 2013 年 1 月至 2017 年 12 月期间在一家机构接受结直肠恶性肿瘤手术的患者的记录。仅纳入行一期吻合的手术患者。在 153 例患者中,乙状结肠和直肠原发肿瘤患者中吻合口漏的发生率为 10.6%,结肠近端原发肿瘤患者中吻合口漏的发生率为 8.2%。单因素分析显示,对于乙状结肠和直肠原发肿瘤患者,延迟经口进食和肿瘤组织学分期较晚与吻合口漏相关,而对于结肠近端原发肿瘤患者,多器官切除和远处转移与吻合口漏相关。总之,吻合口漏发生的危险因素因原发肿瘤位置而异,需要进一步研究以深入了解这些差异。

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