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中国癌症防治杂志

中国癌症防治杂志 ›› 2023, Vol. 15 ›› Issue (5): 564-569.doi: 10.3969/j.issn.1674-5671.2023.05.15

• 临床研究 • 上一篇    下一篇

经肛门拖出标本的全腹腔镜结直肠癌根治术（NOSES Ⅳ式）术后吻合口瘘发生的危险因素分析

  

  1. 滦州市人民医院普外科；山东省军区青岛第十二离职干部休养所；唐山市人民医院放化一科；滦州市人民医院病案室，国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院结直肠外科
  • 出版日期:2023-10-25 发布日期:2023-11-03
  • 通讯作者: 刘春 E-mail：Liuchun19802222@163.com
  • 基金资助:
    中国癌症基金会北京希望马拉松专项基金（LC2019A30）

Analysis of the risk factors of anastomotic leakage after total laparoscopic transrectal specimen extraction surgery (NOSES Ⅳ) for colorectal cancer

  • Online:2023-10-25 Published:2023-11-03

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摘要： 目的 探讨经肛门拖出标本的全腹腔镜结直肠癌根治术（NOSES Ⅳ式）吻合口瘘发生的危险因素。方法 回顾性分析2016年1月至2023年6月在中国医学科学院北京协和医学院肿瘤医院与滦州市人民医院行NOSES Ⅳ式的268例结直肠癌患者的临床病理资料。根据有无发生吻合口瘘，将患者分为吻合口瘘组（n=27）与无吻合口瘘组（n=241），采用单因素、多因素logistic回归分析其危险因素。结果 结直肠癌NOSES Ⅳ式术后吻合口瘘发生率为10.1%。单因素分析显示，男性、肿瘤距肛缘<8 cm、手术时间≥140 min与吻合口瘘有关。多因素logistic回归分析结果显示手术时间≥140 min是行结直肠癌NOSES Ⅳ式患者术后吻合口瘘发生的独立危险因素（OR=5.987，95%CI:1.519~23.602，P=0.011）。结论 手术时间是结直肠癌NOSES Ⅳ式术后吻合口瘘发生的影响因素。

关键词: 结直肠癌, 吻合口瘘, 经自然腔道取标本手术, 危险因素

Abstract: Objective To investigate the risk factors of anastomotic leakage after total laparoscopic transanal natural orifice specimen extraction surgery (NOSES Ⅳ) for colorectal cancer. Methods The clinicopathological data of 268 patients with colorectal cancer who underwent NOSES Ⅳ in the Cancer Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College and Luanzhou People's Hospital from January 2016 to June 2023 were retrospectively analyzed. Patients were divided into the anastomotic leakage group (n=27) and the non⁃anastomotic leakage group (n=241) according to the occurrence of anastomotic leakage. The risk factors were analyzed by both univariable and multivariable logistic regressions. Results The incidence of anastomotic leakage after NOSES Ⅳ for colorectal cancer was 10.1%. The univariable analysis showed that the male patients with tumor distance <8 cm from anal margin and operation time ≥140 min were associated with anastomotic leakage. The multivariable logistic regression analysis showed that a duration of operation ≥140 min was an independent influential factor of postoperative anastomotic leakage in patients who underwent NOSES Ⅳ for colorectal cancer (OR=5.987, 95%CI: 1.519-23.602, P=0.011) Conclusions Operation time is a influential factor for anastomotic leakage after NOSES Ⅳ for colorectal cancer.

Key words: Anastomotic leakage, Colorectal cancer, Natural orifice specimen extraction, Risk factor

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