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根治性结肠癌手术后吻合口瘘发生的危险因素及其对预后的影响。

Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis.

作者信息

Wang Jun, Li Min-Hua

机构信息

Department of Gastrointestinal Surgery, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China.

Department of Gastroenterology, The Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China.

出版信息

World J Gastrointest Surg. 2023 Nov 27;15(11):2470-2481. doi: 10.4240/wjgs.v15.i11.2470.

Abstract

BACKGROUND

Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically. However, postradical surgery is prone to complications such as anastomotic fistulas.

AIM

To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer.

METHODS

We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery. This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi, Jiangsu Province, China. A -test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas. Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas. The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery.

RESULTS

Binary logistic regression analysis revealed that age [odds ratio (OR) = 1.043, = 0.015], tumor, node, metastasis stage (OR = 2.337, = 0.041), and surgical procedure were independent risk factors for postoperative anastomotic fistulas. Multiple linear regression analysis showed that the development of postoperative anastomotic fistula ( = 0.000), advanced age ( = 0.003), and the presence of diabetes mellitus ( = 0.015), among other factors, independently affected prognosis.

CONCLUSION

Postoperative anastomotic fistulas significantly affect prognosis and survival rates. Therefore, focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

摘要

背景

结肠癌是胃肠道常见的恶性肿瘤,通常采用手术治疗。然而,根治性手术后容易出现诸如吻合口瘘等并发症。

目的

探讨术后吻合口瘘的危险因素及其对结肠癌患者预后的影响。

方法

我们对488例行根治性手术的结肠癌患者进行了回顾性分析。本研究于2016年4月至2019年4月在中国江苏省无锡市的一家三级医院进行。采用t检验比较有和无术后吻合口瘘患者之间的实验室指标。进行多因素logistic回归分析以确定术后吻合口瘘的独立危险因素。还采用癌症治疗功能评估-结直肠癌量表评估术后恢复情况。

结果

二元logistic回归分析显示,年龄[比值比(OR)=1.043,P=0.015]、肿瘤-淋巴结-转移分期(OR=2.337,P=0.041)和手术方式是术后吻合口瘘的独立危险因素。多元线性回归分析表明,术后吻合口瘘的发生(P=0.000)、高龄(P=0.003)和糖尿病的存在(P=0.015)等因素独立影响预后。

结论

术后吻合口瘘显著影响预后和生存率。因此,关注临床特征和危险因素并立即实施个体化预防措施对于减少其发生至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b59f/10725546/9d173f2cca40/WJGS-15-2470-g001.jpg

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