结肠癌D3根治术后32例吻合口瘘原因探讨与后期治疗
发布时间:2018-04-30 13:13
本文选题:结肠癌D3根治术 + 术后并发症 ; 参考:《山东大学》2015年硕士论文
【摘要】:目的:本文通过对我院胃肠外科2008.01.01-2014.0101六年间行结肠癌D3根治术后患者1124例,术后32例出现吻合口瘘的回顾性分析,探讨结肠癌D3根治术后吻合口瘘的原因、诊断、后期治疗以及预防措施。材料及方法:本回顾性分析2008年1月1日至2014年1月1日收治的1124例结肠癌根治术32例术后吧并发吻合口瘘患者的临床资料,比较性别、年龄、体型、糖尿病、术前低蛋白血症、肿瘤位置、肿瘤分期、手术方式、手术时间长短等对术后吻合口瘘的影响。结果:1124例患者中32例术后发生吻合口瘘,发生率为2.8%。左半结肠癌499例术后吻合口瘘23例,右半结肠癌513例术后吻合口瘘8例,横结肠癌112例术后吻合口瘘1例。按Dukes分期标准,A期178例术后吻合口瘘4例,B期123例术后吻合口瘘3例,C期535例术后吻合口瘘17例,D期288例术后吻合口瘘8例。在所分析的9个因素中,性别、年龄、体型、糖尿病、术前低蛋白血症、肿瘤位置、手术时间与吻合口瘘的发生存在统计学意义,而手术方式和肿瘤分期与术后吻合口瘘的发生无明显相关。结论:结肠癌D3根治术后吻合口瘘多发生在左半结肠,性别、年龄、体型、糖尿病、术前低蛋白血症、肿瘤位置、手术时间与吻合口瘘的发生有明显相关性。吻合口瘘的治疗首选保守支持治疗。急性期应完全禁饮食,完全肠外营养,待状况好转后积极开展无渣饮食。尽早恢复肠内饮食有助于病情恢复。
[Abstract]:Objective: to investigate the causes and diagnosis of anastomotic fistula after radical resection of colon cancer in 1124 cases and 32 cases after radical resection of colon cancer during 2008.01.01-2014.0101 in our hospital. Late treatment and preventive measures. Materials and methods: from January 1, 2008 to January 1, 2014, we retrospectively analyzed the clinical data of 32 patients with anastomotic fistula after radical resection of colon cancer, and compared their sex, age, body size, diabetes mellitus. The effect of preoperative hypoproteinemia, tumor location, tumor staging, operation mode and operation time on postoperative anastomotic fistula. Results 32 cases of anastomotic fistula occurred in 32 cases of 1 124 cases. The incidence of anastomotic leakage was 2.8%. Anastomotic fistula was found in 23 cases of 499 cases of left colon cancer, 8 cases of anastomotic fistula in 513 cases of right colon cancer and 1 case of anastomotic fistula in 112 cases of transverse colon cancer. According to the standard of Dukes stage A, there were 4 cases of anastomotic fistula in stage A and 123 cases in stage B, 3 cases in stage C, 535 cases in stage C, 17 cases of anastomotic fistula in D stage and 288 cases of postoperative anastomotic fistula in 8 cases. Among the 9 factors analyzed, sex, age, body size, diabetes mellitus, preoperative hypoproteinemia, tumor location, operative time and anastomotic leakage were statistically significant. However, there was no significant correlation between postoperative anastomotic fistula and surgical operation and tumor staging. Conclusion: anastomotic fistula after radical resection of colon cancer D3 is associated with the occurrence of anastomotic fistula in the left colon, sex, age, body type, diabetes mellitus, preoperative hypoproteinemia, tumor location and operation time. The first choice of treatment for anastomotic fistula is conservative support therapy. Diet and parenteral nutrition should be completely prohibited in acute period. Early recovery of enteral diet is helpful for recovery.
【学位授予单位】:山东大学
【学位级别】:硕士
【学位授予年份】:2015
【分类号】:R735.35
【参考文献】
相关期刊论文 前1条
1 Fabio Grizzi;Paolo Bianchi;Alberto Malesci;Luigi Laghi;;Prognostic value of innate and adaptive immunity in colorectal cancer[J];World Journal of Gastroenterology;2013年02期
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