CAJ | 학술논문

目的分析直肠癌根治术后吻合口瘘的危险因素,探讨高位结扎肠系膜下动脉对直肠癌术后吻合口瘘的影响.方法对2008年8月至2011年11月期间291例行直肠癌根治术患者的临床资料进行回顾性分析,采用x2检验及t检验进行数据分析.结果 291例中共有27例术后发生吻合口瘘(9.3％),其中男性(P =0.048)、肿瘤位置(P =0.028)及术中失血量(P=0.015)为术后吻合口瘘的危险因素.高位结扎肠系膜下动脉与肿瘤距肛缘的距离(P =0.009)和手术方式(P=0.041)有关,并影响肿瘤的TNM分期(P =0.024)及术后尿潴留的发生率(P =0.025),但未增加术后吻合口瘘的发生率(P =0.563).结论男性、肿瘤位置及术中失血量为直肠癌根治术后吻合口瘘的危险因素,高位结扎肠系膜下动脉并未增加直肠癌术后吻合口瘘的发生率.
목적 분석직장암근치술후문합구루적위험인소,탐토고위결찰장계막하동맥대직장암술후문합구루적영향.방법 대2008년8월지2011년11월기간291례행직장암근치술환자적림상자료진행회고성분석,채용x2검험급t검험진행수거분석.결과 291례중공유27례술후발생문합구루(9.3％),기중남성(P =0.048)、종류위치(P =0.028)급술중실혈량(P=0.015)위술후문합구루적위험인소.고위결찰장계막하동맥여종류거항연적거리(P =0.009)화수술방식(P=0.041)유관,병영향종류적TNM분기(P =0.024)급술후뇨저류적발생솔(P =0.025),단미증가술후문합구루적발생솔(P =0.563).결론 남성、종류위치급술중실혈량위직장암근치술후문합구루적위험인소,고위결찰장계막하동맥병미증가직장암술후문합구루적발생솔.
Objective To identify risk factors for anastomotic leakage,and study the influence of high ligation of the inferior mesenteric artery on anastomotic leakage after rectal cancer resection.Methods The chi-test and the student t test were used for statistics.Clinical data were analyzed for 291 patients who underwent rectal cancer resection between August 2008 and November 2011.Results Anastomotic leakage occurred in 27 (9.3％) patients.Anastomotic leakage significantly increased in patients with tumours located within 10 cm from the anal verge,in male patients,and intraoperative blood loss.The use of high ligation of inferior mesenteric artery,which was associated with lower tumor location and surgical modality,was not a risk factor for anastomotic leakage,though it was associated with tumor stage and postoperative urinary retention.Conclusions Anastomotic leakage after rectal cancer resection is related to the tumor level,male gender,and perioperative bleeding,use of a high tie was not associated with an increased rate of symptomatic anastomotic leakage.