肥胖直肠癌患者的临床病理特征及近期手术效果

V. Oter, Özcem Öfkeli, M. Ulaş, I. Ozer, E. Bostancı
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引用次数: 0

摘要

目的:一些作者将体重指数(BMI)的增加与直肠癌术后并发症发生率的增加、淋巴结数量的减少以及保留肛门括约肌在直肠癌手术治疗中更具挑战性联系起来。在这项研究中,我们评估了肥胖和非肥胖直肠癌患者的临床病理特征和短期手术结果。材料与方法:对54例肥胖患者和326例非肥胖患者的临床病理特征、术后并发症、再手术率和死亡率进行评估。结果:肥胖患者直肠远端肿瘤发生率明显高于非肥胖患者(p<0.05)。虽然前切除术在组i中更常见,但腹会阴切除术在组ii中明显更高,(p<0.05)。两组术后除术后总并发症及吻合口瘘再手术外,两组术后结果基本一致。虽然两组吻合口瘘的再手术率存在差异,但两组吻合口瘘再手术率非常接近,差异无统计学意义。与之前发表的一些文章不同,在我们的研究中,两组患者的发病率和死亡率没有显著差异。结论:我们认为在切除足够数量淋巴结的情况下改变手术策略尚无明确的结论,但应采用细致的技术来降低本组患者吻合口漏的发生率和再手术率。
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Clinicopathologic features of obese patients with rectal cancer and short-term results of surgery
Aim: Some authors related the increased body mass index (BMI) with postoperative complication rates also increase, number of harvested lymph nodes reduce and sparing the anal sphincter is much more challenging in the surgical management of rectal cancer. In this study, we evaluated clinic-pathologic features and short-term surgical results in obese and non-obese patients with rectal cancer. Material and Methods: 54 obese and 326 non-obese patients are evaluated for clinic-pathological features, postoperative complications, re-operation rates and mortality rates. Results: The rate of distally located rectal tumor is found significantly higher in obese patients than non-obese patients (p<0.05). Although anterior resection has been performed more commonly in Group-I, abdominoperineal resection procedure is found significantly higher in Group-II, (p<0.05)..Harvested lymph nodes ratio between two groups was quite close to each other so this difference is not statistically significant. .Postoperative results were similar between the groups except total postoperative complications and re-operations for anastomotic leak. Although re-operation rates for anastomotic leak are found different, they are quite close between the two groups and this difference is not statistically significant. In contrast to some of the previously published articles, there was not any significant difference in morbidity and mortality between the two groups in our study. Conclusion: In our opinion there is not a clear conclusion to change the operative strategy for enough number of harvested lymph nodes but meticulous technique should be utilized to reduce the rate of anastomotic leak and resultant re-operations in this group of patients.
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