Risk factors associated with anastomotic leakage in patients operated due to colorectal tumours.
Risk factors associated with anastomotic leakage in patients operated due to colorectal tumours.
复制标题
结直肠肿瘤手术患者吻合口漏的相关危险因素。
DOI：
10.17392/1013-19
复制
发表时间：
2019
期刊：
影响因子：
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通讯作者：
M. Alkan
中科院分区：
文献类型：
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作者：
O. Altın;M. Alkan
目的探讨结直肠癌切除吻合术后发生吻合口瘘的危险因素。方法选取2014年1月至2018年7月在我院门诊行结直肠癌切除吻合术的患者。将患者分为两组，即AL为1组，无AL为2组。对两组患者的临床特征、手术和病理结果进行单因素和多因素分析。结果共纳入302例患者。24例（7.9%）患者观察到AL。第1组和第2组分别有5例（20.8%）和6例（2.2%）患者死亡（p=0.001）。单变量分析中AL的显著危险因素为冠状动脉疾病（CAD）、慢性阻塞性肺疾病、美国麻醉医师协会（阿萨）评分高、紧急手术干预、术前肠道准备缺失、围手术期输血、肿瘤T分期和新辅助放化疗应用。在多因素分析中，只有CAD和新辅助CRT被确定为AL的独立危险因素。结论结直肠手术后AL的发生仍是一个重要的问题，从而增加死亡率和发病率沿着其对住院时间、功能和肿瘤结果的负面影响。尽管有一些关于这个主题的研究，但仍然很难提前估计AL的可能性。因此，避免高风险患者的吻合术可能是最好的选择。
Aim To evaluate risk factors that may cause anastomotic leakage (AL) in patients who underwent resection and anastomosis due to colorectal cancer. Methods Patients who underwent resection and anastomosis due to colorectal cancer between January 2014 and July 2018 in our clinic were included into the study. The patients were divided into two groups as ones with AL being Group 1, ones without AL being Group 2. Parameters related to the clinical characteristics, surgical and pathologic results in both groups were evaluated with univariate and multivariate analyses. Results A total of 302 patients were included in the study. The AL was observed in 24 (7.9%) patients. Mortality was observed in five (20.8%) and six (2.2%) patients in Group 1 and Group 2, respectively (p=0.001). Significant risk factors for AL in the univariate analysis were coronary artery disease (CAD), chronic obstructive pulmonary disease, high American Society of Anesthesiologists (ASA) score, emergency surgical intervention, absence of preoperative intestine preparation, performed perioperative blood transfusion, tumour T stage, and neoadjuvant chemo-radiotherapy application. Only CAD and neoadjuvant CRT were determined as the independent risk factors for AL in the multivariate analysis. Conclusion The AL developing after colorectal surgery continues to be an important problem thereby increasing mortality and morbidity along with its negative effect on hospitalization time and functional and oncologic results. Despite several studies on the topic, it is still very difficult to estimate the AL possibility in advance. Therefore, avoiding anastomosis in high risk patients may perhaps be the best option.