摘要
目的讨论直肠癌腹腔镜手术中关闭盆底腹膜对术后早期机械性肠梗阻发生的影响及相关影响因素。方法选取低位直肠癌患者共131例,分为关闭盆底腹膜组和未关闭盆底腹膜组。比较术后早期机械性肠梗阻的发生情况,并分析相关影响因素。结果腹腔镜手术治疗低位直肠癌后机械性肠梗阻的总发生率为8.40%,腹腔镜手术中未关闭盆底腹膜组患者中术后肠梗阻发生率、切口感染的发生率、左半结肠切除以及右半结肠切除均高于关闭盆底腹膜组,差异均具有统计学意义(P<0.05)。单因素分析发现,影响患者术后早期肠梗阻与TNM N2期、术中大出血、切口感染,左半结肠切除和右半结肠切除以及关闭盆底腹膜有关,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示TNM N2期、术中大出血、切口感染,左半结肠切除和右半结肠切除以及关闭盆底腹膜是影响患者早期肠梗阻的危险因素。结论低位直肠癌腹腔镜手术中关闭盆底腹膜可以减低术后早期机械性肠梗阻发生的风险。
Objective To investigate the effect of pelvic floor peritoneum on early postoperative mechanical intestinal obstruction in laparoscopic surgery for rectal cancer patients,and also the relative influencing factors. Methods A total of 131 patients with rectal cancer were divided into 2 groups in this study： the pelvic peritoneum group and the pelvic peritoneum group.The incidence of early postoperative mechanical obstruction between the 2 groups was compared and the related influencing factors were analyzed. SPSS17. 0 was used to complete statistical analysis. Results Laparoscopic surgery in the treatment of low rectal cancer after intestinal mechanical obstruction. The total incidence was 8. 40%. Laparoscopic surgery is not closed postoperative intestinal obstruction in patients with pelvic peritoneum incidence,the incidence rate of incision infection,left hemicolectomy and right hemicolectomy were higher than those of closed abdominal pelvic membrane group,the differences were statistically significant（ P〈0. 05）. Univariate analysis showed that patients with early postoperative intestinal obstruction and TNM N2 time,intraoperative bleeding,incision infection,left hemicolectomy and right hemicolectomy and pelvic peritoneum was closed,the difference was statistically significant（ P〈0. 05）. Multivariate Logistic regression analysis showed that TNM N2 stage,intraoperative bleeding,incision infection,left colectomy and right colon resection,and closing pelvic floor peritoneum were risk factors for early intestinal obstruction. Conclusion Laparoscopic surgery for rectal cancer can reduce the risk of early postoperative mechanical intestinal obstruction.
作者
汪雪
王梦桥
刘建
彭德伟
李锋
WANG Xue;WANG Mengjiao;LIU Jian(The Fifth People＇s Hospital of Chengdu,Chengdu,611130)
出处
《实用癌症杂志》
2018年第9期1452-1454,共3页
The Practical Journal of Cancer
关键词
腹腔镜
直肠癌
肠梗阻
盆底腹膜
危险因素
Laparoscopy
Rectal cancer
Intestinal obstruction
Pelvic floor peritoneum
Risk factors
