Pollard C W, Nivatvongs S, Rojanasakul A, Ilstrup D M
Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota 55905.
Dis Colon Rectum. 1994 Sep;37(9):866-74. doi: 10.1007/BF02052590.
The aim of this study was to determine the incidence and risk factors that were significant in contributing the intraoperative and early postoperative complications for operations of carcinoma of the rectum.
Between 1984 and 1986 inclusive, 426 patients underwent surgery for primary adenocarcinoma of the rectum. Cases of local excision were excluded. The relationship between each complication and nominal risk factors were studied. The types of surgery included an abdominoperineal resection, low anterior resection, low anterior resection with coloanal anastomosis, anterior resection, colostomy, and Hartmann's procedure.
There were two (0.5 percent) deaths. Intraoperative complications occurred in 34 (8 percent) patients. The most common intraoperative complication was presacral bleeding which occurred in 14 patients. Postoperative complications occurred in 214 (50 percent) patients. The two most common complications were urinary retention and urinary tract infection. Abdominoperineal resection had the highest early postoperative complication rate (59 percent). There were 17 clinical anastomotic leaks (7 percent in 221 patients with unprotected anastomoses). The development of complications reached statistical significance with increasing age (P = 0.003), male sex (P = 0.003), increasing weight (P = 0.006), and types of operative procedure (P = 0.001).
Operations for carcinoma of the rectum can be performed with low mortality. Although the overall early postoperative complications were high, the majority was not life-threatening and usually resolved with time and proper management.
本研究旨在确定对直肠癌手术术中及术后早期并发症有显著影响的发生率及风险因素。
在1984年至1986年（含）期间，426例患者接受了原发性直肠癌手术。局部切除病例被排除。研究了每种并发症与名义风险因素之间的关系。手术类型包括腹会阴联合切除术、低位前切除术、低位前切除结肠肛管吻合术、前切除术、结肠造口术和哈特曼手术。
有2例（0.5%）死亡。34例（8%）患者发生术中并发症。最常见的术中并发症是骶前出血，发生在14例患者中。214例（50%）患者发生术后并发症。最常见的两种并发症是尿潴留和尿路感染。腹会阴联合切除术的术后早期并发症发生率最高（59%）。有17例临床吻合口漏（221例未保护吻合口患者中占7%）。并发症的发生随着年龄增加（P = 0.003）、男性（P = 0.003）、体重增加（P = 0.006）和手术方式（P = 0.001）而具有统计学意义。
直肠癌手术死亡率较低。虽然术后早期总体并发症发生率较高，但大多数并不危及生命，通常随着时间推移和适当处理会得到缓解。
