目的:探讨行低位直肠前切除术的直肠癌患者出现重度低位前切除综合征(LARS)的危险因素。方法:选取2019 年2 月至2021 年 5 月于承德医学院附属医院行直肠癌低位前切除术的 156例患者作为研究对象。通过电话随访、门诊随访等方式对患者进行术后评估，计算LARS 量表得分。采用单因素分析和多因素Logistic回归分析探究发生重度 LARS 的影响因素。结果:156 例患者中，术后69 例(44。23%)发生LARS，其中轻度LARS 34 例(21。79%)，重度 LARS 35 例(22。44%)。单因素分析结果表明，肥胖、术前实施新辅助放疗、吻合口距齿线高度≤2cm、术后并发吻合口漏与重度 LARS 发生具有关联性(P<0。05)。多因素回归分析结果显示，术前实施新辅助放疗、吻合口距齿线高度≤2cm、BMI≥25kg/m2 以及术后患者发生吻合口漏与重度LARS密切相关。结论:低位直肠癌患者术后存在较高LARS发生率，肥胖、新辅助放疗、吻合口距离≤2cm、术后并发吻合口漏是重度 LARS 发生的独立危险因素。
Analysis of Risk Factors for Severe Low Anterior Resection Syndrome After Low Anterior Resection for Rectal Cancer
Objective:To investigate the hazard factors for severe low anterior resection syndrome(LARS)in patients with rectal cancer after low anterior resection.Methods:A total of 156 patients who un-derwent low anterior resection for rectal cancer at the Affiliated Hospital of Chengde Medical College from Feb-ruary 2019 to May 2021 were selected as the study subjects.The patients were evaluated postoperatively by telephone follow-up and outpatient visits,and the LARS score was calculated.Univariate and multivariate lo-gistic regression analyses were used to explore the factors influencing the occurrence of severe LARS.Results:Among the 156 patients,69 cases(44.23%)developed LARS,including 34 cases of mild LARS(21.79%)and 35 cases of severe LARS(22.44%).Univariate analysis indicated that neoadjuvant radiotherapy,obesi-ty,height of anastomosis to tooth line(≤2cm),and stomal leak after operation were closely related to severe LARS.Multivariate regression analysis showed that preoperative neoadjuvant radiotherapy,anastomosis-to-dentate line height less than 2cm,BMI≥25kg/m2,and postoperative anastomotic leakage were closely relat-ed to the occurrence of severe LARS.Conclusion:Patients with low anterior resection have a higher risk of LARS.Obesity,neoadjuvant radiotherapy,anastomosis distance less than 2cm,and postoperative anastomotic leakage are independent risk factors for severe LARS.
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