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结直肠癌术后吻合口良性狭窄的临床分析

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目的 分析结直肠癌患者同时行预防性回肠造口术后吻合口出现良性狭窄的影响因素及处理方法.方法 选取福建医科大学附属泉州市第一医院 2018 年 4 月至 2022 年 6 月收治的 74 例行预防性回肠造口的结直肠癌患者的临床资料,根据术后有无吻合口狭窄将患者分为吻合口狭窄组、吻合口正常组,采用统计学方法分析狭窄的影响因素,并总结吻合口狭窄的处理方法.结果 术后发生吻合口狭窄 15 例,发生率 20.3%.与吻合口正常组比较,吻合口狭窄组患者术前放疗、术前新辅助化疗的比例及术后吻合口漏/盆腔感染发生率更高,差异有统计学意义(P<0.05);多因素分析提示术前放疗、吻合口漏/盆腔感染为吻合口狭窄的独立危险因素.结论 术前行放疗、新辅助化疗、术后吻合口漏/盆腔感染的结直肠癌患者在还纳回肠造口后需注意吻合口狭窄的发生;术后吻合口狭窄应根据狭窄的特点选择治疗方式.
Clinical analysis of benign anastomotic stenosis after colorectal cancer surgery
Objective To analyze the influencing factors and management of benign anastomotic stenosis in patients with colorectal cancer after concurrent prophylactic ileostomy.Methods The clinical data of 74 colorectal cancer patients undergoing preventive ileostomy admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from April 2018 to June 2022 were selected,according to the presence or absence of anastomotic stenosis after surgery,patients were divided into anastomotic stenosis group and anastomotic normal group.The influencing factors of stenosis were analyzed using statistical methods,and the management methods for anastomotic stenosis were summarized.Results 15 cases of anastomotic stenosis occurred after surgery,with an incidence rate of 20.3%.Compared with anastomotic normal group,patients in anastomotic stenosis group had a higher proportion of preoperative radiation therapy,preoperative neoadjuvant chemotherapy,and a higher incidence of postoperative anastomotic leakage/pelvic infection,with statistical significance(P<0.05);Multivariate analysis suggests that preoperative radiotherapy,anastomotic leakage/pelvic infection are independent risk factors for anastomotic stenosis.Conclusion Patients with colorectal cancer who undergo preoperative radiotherapy,neoadjuvant chemotherapy,and postoperative anastomotic leakage/pelvic infection should pay attention to the occurrence of anastomotic stenosis after undergoing ileostomy;Postoperative anastomotic stenosis should be treated according to the characteristics of the stenosis.

Colorectal cancerAnastomotic stenosisRisk factors

郑伟、黄书荣、傅永安、林鸿悦、陈锦萍

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福建医科大学附属泉州市第一医院胃肠外科1区,福建泉州 362000

结直肠癌 吻合口狭窄 危险因素

2024

中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
年,卷(期):2024.62(9)
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