CAJ | 학술논문

目的：研究直肠癌保肛手术后发生吻合口漏的原因，探索预防性造瘘的指征。方法以徐州医学院附属医院2004年3月至2014年3月收治的816例直肠癌保肛手术患者作为研究对象，收集其年龄、性别、基础疾病、营养状态、吸烟史、酗酒史，结合术中出血量、手术时间、吻合口高度等资料，观察以上因素与术后吻合口漏的关系，并进行统计学分析。结果男性、年龄≥65岁、糖尿病、酗酒、吻合口高度≤5cm、手术时间>3小时的患者术后出现吻合口漏的概率较其相应对照组高，差异有统计学意义。结论性别、年龄、糖尿病、酗酒、低位吻合及手术时间等指标作为直肠癌保肛手术后吻合口漏的危险因素，对于评估术中行预防性造瘘的必要性有重要临床意义。
목적：연구직장암보항수술후발생문합구루적원인，탐색예방성조루적지정。방법이서주의학원부속의원2004년3월지2014년3월수치적816례직장암보항수술환자작위연구대상，수집기년령、성별、기출질병、영양상태、흡연사、후주사，결합술중출혈량、수술시간、문합구고도등자료，관찰이상인소여술후문합구루적관계，병진행통계학분석。결과남성、년령≥65세、당뇨병、후주、문합구고도≤5cm、수술시간>3소시적환자술후출현문합구루적개솔교기상응대조조고，차이유통계학의의。결론성별、년령、당뇨병、후주、저위문합급수술시간등지표작위직장암보항수술후문합구루적위험인소，대우평고술중행예방성조루적필요성유중요림상의의。
Objective To investigate the reasons of anastomotic leakage ( AL ) after sphincter preserving surgery of rectal cancer, and find the indications for defunctioning stoma. Methods 816 rectal cancer patients who underwent sphincter preserving surgery in our hospital from Mar. 2004 to Mar. 2014 were treated as research subjects. Factors such as their age, gender, underlying diseases, nutritional status, smoking history and alcohol abuse, blood loss, operative time, anatomotic height were collected for researching. The relationship between AL and the collecting factors were statistically analyzed. Results The rates of AL of male, aged ≥65 years, diabetes, alcoholism, anastomosis height≤5cm, the length of surgery more than three hours, are significantly higher than their corresponding control group. Conclusions Gender, age, diabetes, alcoholism, low anastomo-sis and surgical time can be treated as risk factors for AL following sphincter preserving surgery, and these fac-tors might play important roles in evaluating the necessity of defunctioning stoma.