高龄患者腹腔镜结直肠手术后发生术后麻痹性肠梗阻的危险因素：对124例连续患者的回顾性研究
Risk Factors for Postoperative Paralytic Ileus in Advanced-age Patients after Laparoscopic Colorectal Surgery: A Retrospective Study of 124 Consecutive Patients.
作者信息
Fujimoto Takaaki, Manabe Tatsuya, Yukimoto Kumpei, Tsuru Yasuhiro, Kitagawa Hiroshi, Okuyama Keiichiro, Takesue Shin, Kai Keita, Noshiro Hirokazu
机构信息
Department of Surgery, Saga University Faculty of Medicine, Nabeshima, Japan.
Department of Pathology, Saga University Hospital, Nabeshima, Japan.
出版信息
J Anus Rectum Colon. 2023 Jan 25;7(1):30-37. doi: 10.23922/jarc.2022-044. eCollection 2023.
OBJECTIVES
Postoperative paralytic ileus (POI) is one of the most common and troublesome complications following colorectal surgery. However, to date, the risk factors for POI remain unclear. This study aimed to identify the risk factors for POI following laparoscopic colorectal surgery in advanced-age patients.
METHODS
The clinical data of 124 patients aged ≥75 years who underwent curative colorectal surgery from January 2018 to December 2020 were retrospectively reviewed. The relationship between POI and clinicopathological data including sarcopenia and visceral fat obesity was then assessed. Sarcopenia was defined as a low skeletal muscle mass index; visceral obesity, visceral fat with an area ≥100 cm on computed tomography at the level of the third lumbar vertebra; and sarcobesity, sarcopenia with visceral obesity.
RESULTS
The rate of POI was 9% (12/124 patients), and all the affected patients improved with conservative treatment. In the univariate and multivariate analyses, sarcopenia and sarcobesity were significant predictive factors for POI.
CONCLUSIONS
Sarcopenia and sarcobesity may be risk factors for POI in patients aged ≥75 years after laparoscopic colorectal surgery.
目的
术后麻痹性肠梗阻（POI）是结直肠手术后最常见且棘手的并发症之一。然而，迄今为止，POI的危险因素仍不明确。本研究旨在确定老年患者腹腔镜结直肠手术后POI的危险因素。
方法
回顾性分析2018年1月至2020年12月期间124例年龄≥75岁接受根治性结直肠手术患者的临床资料。然后评估POI与包括肌肉减少症和内脏脂肪肥胖在内的临床病理数据之间的关系。肌肉减少症定义为低骨骼肌质量指数；内脏肥胖定义为在第三腰椎水平计算机断层扫描上内脏脂肪面积≥100 cm²；肌少型肥胖定义为伴有内脏肥胖的肌肉减少症。
结果
POI发生率为9%（12/124例患者），所有受累患者经保守治疗后均有改善。在单因素和多因素分析中，肌肉减少症和肌少型肥胖是POI的显著预测因素。
结论
肌肉减少症和肌少型肥胖可能是≥75岁患者腹腔镜结直肠手术后发生POI的危险因素。
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