结肠渗漏评分在左侧结直肠手术中的应用。

Gustavo Martínez-Mier, Miguel A Carrasco-Arroniz, Ana G De Los Santos-Lopez, José M Reyes-Ruiz
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摘要

背景:结肠瘘评分(CLS)用于预测左侧结直肠手术吻合口瘘(AL)的风险。虽然漏出的危险因素是众所周知的,并被外科社区所接受,但准确预测AL仍然是一项艰巨的任务。目的:研究CLS在左侧结直肠手术患者中的应用。方法:对左侧结直肠手术一期吻合不转移造口患者进行回顾性研究。计算患者的CLS,将患者分为AL组和NO-AL组。通过接收机操作者特征评价CLS的预测价值。测定CLS与AL的相关性。208例患者(55%为男性,平均年龄59岁)纳入研究。结果:总体AL为7.2%。所有患者的平均CLS为7.2±3.2(0-17)。AL患者的CLS(11.8±2.3)高于NO-AL患者(6.8±3)(p = 0.0001)。CLS预测AL的曲线下面积为0.898 ([CI] 0.829-0.968, p = 0.0001)。CLS为8.5,敏感性93%,特异性72%。CLS和AL的优势比有统计学意义(0.58:[CI] 0.46-0.73, p = 0.0001)。结论:CLS是预测左侧结直肠手术AL的有效工具。
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Application of colon leakage score in the left-sided colorectal surgery.

Background: Colon leakage score (CLS) was developed for risk prediction of anastomotic leak (AL) in the left-sided colorectal surgery. Although the risk factors for leakage are well known and accepted by the surgical community, an accurate forecast of AL is still a difficult task.

Objective: The study aims to apply the CLS in patients undergoing left-sided colorectal surgery.

Methods: Retrospective study in patients with the left-sided colorectal surgery and primary anastomosis without diverting stoma. CLS was calculated in patients, who were classified in AL and NO-AL groups. Predictive value of CLS was evaluated by receiver operator characteristic. Correlation between CLS and AL was determined. 208 patients (55% male, mean age 59 years) were included in the study.

Results: Overall, AL was 7.2%. Mean CLS of all patients was 7.2 ± 3.2 (0-17). Patients with AL had a higher CLS (11.8 ± 2.3) than NO-AL patients (6.8 ± 3) (p = 0.0001). The area under the curve for the prediction of AL by CLS was 0.898 ([CI] 0.829-0.968, p = 0.0001). A CLS of 8.5 had 93% sensitivity and 72% specificity. There was a statistically significant odds ratio for CLS and AL (0.58: [CI] 0.46-0.73, p = 0.0001).

Conclusion: CLS is a useful tool to predict AL in the left-sided colorectal surgery.

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