结直肠癌手术中回肠结肠吻合口破裂

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY Gastrointestinal disorders (Basel, Switzerland) Pub Date : 2023-06-12 DOI:10.3390/gidisord5020022
Sara Lima Gomes, P. Santos, J. Costa Pereira, Sandra F. Martins
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引用次数: 0

摘要

背景:吻合口渗漏(AL)是癌症(CRC)手术中最令人担忧的并发症之一。尽管许多系列报道了AL的一般危险因素,但已发表的关于回结肠吻合的研究很少。本研究的主要目的是确定CRC手术中与回结肠吻合口裂开相关的潜在危险因素。方法:纳入2018年11月至2022年2月在布拉加医院接受选择性CRC手术后的188名患者。对AL的独立危险因素进行了多元logistic回归分析。结果:AL发生在13例患者中(6.9%),其中约四分之三的患者需要手术再干预。死亡率为5.3%。糖尿病、ASA评分≥3、剖腹手术或转为剖腹手术、术后输血和术后低白蛋白血症与AL风险增加有关。在多变量分析中,术后低蛋白血症(p=0.018;OR:0.281;CI:0.098;0.806)和手术时间短(p=0.038;OR:0.985;CI:0.972;0.999)是AL的独立危险因素。
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Ileocolic Anastomosis Dehiscence in Colorectal Cancer Surgery
Background: Anastomotic leakage (AL) is one of the most feared complications in colorectal cancer (CRC) surgery. Although many series have reported the general risk factors for AL, published studies focusing on ileocolic anastomosis are scarce. The main aim of this study was to identify potential risk factors associated with ileocolic anastomosis dehiscence in surgery for CRC. Methods: A total of 188 patients who underwent primary ileocolic anastomosis after elective CRC surgery in Braga’s Hospital from November of 2018 to February of 2022 were included. A multivariate logistic regression analysis was carried out to identify independent risk factors for AL. Results: AL occurred in 13 patients (6.9%), and about three-fourths of these patients required surgical re-intervention. The mortality rate was 5.3%. Diabetes mellitus, ASA score of ≥3, laparotomy or conversion to laparotomy approach, postoperative blood transfusion, and postoperative hypoalbuminemia were associated with an increased risk of AL. In the multivariable analysis, postoperative hypoalbuminemia (p = 0.018; OR: 0.281; CI: 0.098; 0.806) and shorter operating time (p = 0.038; OR: 0.985; CI: 0.972; 0.999) were independent risk factors for AL. Conclusions: Postoperative hypoalbuminemia and shorter operating time are independent risk factors for AL after ileocolic anastomosis.
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审稿时长
10 weeks
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