Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study
Risk factors for anastomotic leakage after rectal cancer surgery: a case-control study
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DOI：
10.1111/j.1463-1318.2007.01466.x
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发表时间：
2008-09-01
影响因子：
3.4
通讯作者：
Gunnarsson, U.
中科院分区：
文献类型：
--
作者：
Jestin, P.;Pahlman, L.;Gunnarsson, U.
背景随着直肠癌手术中引入全直肠系膜切除技术和术前放疗，局部复发率降低，总生存率提高。然而，其一个缺点是吻合口漏率较高，约为 10-18%。男性和低位吻合是这种渗漏的已知危险因素。本研究的目的是确定潜在的可改变的危险因素。 方法 在一项病例对照研究中，对瑞典直肠癌登记处（1995-2000 年）的数据进行了分析。病例均为前切除术后发生吻合口瘘的患者（n = 134）。每个病例随机选择两个对照。根据研究方案检查医疗记录 (n = 402)。由于记录不正确，两名病例和 28 名对照被排除在进一步分析之外。 结果 在多变量分析中，显着的危险因素是美国麻醉医师协会评分 > 2 [OR = 1.40 (95% CI 1.05-1.83)]、术前放疗 [OR = 1.34 (95% CI 1.06-1.69)]、术中不良事件 [OR = 1.85 (95% CI) 1.32-2.58)]，吻合水平
Background With introduction of the total mesorectal excision technique and preoperative radiotherapy in rectal cancer surgery, the local recurrence rate has decreased and the overall survival has improved. One drawback, however, is the high anastomotic leakage rate of approximately 10-18%. Male gender and low anastomoses are known risk factors for such leakage. The aim of this study was to identify potentially modifiable risk factors.Method In a case-control study, data from the Swedish Rectal Cancer Registry (1995-2000) were analysed. Cases were all patients with anastomotic leakage after an anterior resection (n = 134). Two controls were randomly selected for each case. The medical records (n = 402) were checked against a study protocol. Due to incorrect recording two cases and 28 controls were excluded from further analyses.Results In the multivariate analysis significant risk factors were American Society of Anesthesiologists score > 2 [OR = 1.40 (95% CI 1.05-1.83)], preoperative radiotherapy [OR = 1.34 (95% CI 1.06-1.69)], intraoperative adverse events [OR = 1.85 (95% CI 1.32-2.58)], level of anastomosis