【摘要】 目的：探讨腹腔镜直肠癌根治术吻合口瘘发生的危险因素。方法：回顾性分析2018—2023年盐城市第三人民医院收治的349例腹腔镜直肠癌根治术患者的相关资料，统计吻合口瘘发生情况。采用logistic回归分析探寻腹腔镜直肠癌根治术术后吻合口瘘的独立影响因素。结果：单因素分析结果显示，两组患者年龄、营养状态、入院白蛋白、合并糖尿病、保留左结肠动脉、肿瘤下缘距肛缘距离、术中器械选择使用不当、预防性造瘘比较，差异均有统计学意义（P<0.05）。logistic回归分析结果显示，年龄、营养状态、入院白蛋白、合并糖尿病、肿瘤下缘距肛缘距离、术中器械选择使用不当、预防性造瘘均是吻合口瘘的独立危险因素（P<0.05）。结论：对直肠癌患者行腹腔镜直肠癌根治术会有一定几率发生吻合口瘘，其发生与性别、年龄、营养状态、入院白蛋白、合并糖尿病、肿瘤下缘距肛缘距离、术中器械选择使用不当、预防性造瘘等多个因素有关。更多还原

【Abstract】 Objective:To explore risk factors for anastomotic fistula formation following laparoscopic radical resection for rectal cancer.Methods:A retrospective analysis was conducted on 349 patients who underwent laparoscopic radical resection for rectal cancer at Yancheng Third People’s Hospital from 2018 to 2023. The incidence of anastomotic fistula was counted. Logistic regression analysis was used to explore independent factors influencing anastomotic fistula formation following laparoscopic radical resection for rectal cancer.Results:Univariate analysis revealed statistically significant differences between the two groups in age,nutritional status, albumin level at admission, concomitant diabetes, preservation of the left colic artery, distance from tumor margin to anal margin, inappropriate intraoperative instrument selection, and prophylactic stoma creation(P<0.05). Logistic regression analysis revealed that age, nutritional status, albumin level at admission, concomitant diabetes, distance from tumor margin to anal margin, improper selection of surgical instruments, and prophylactic stoma creation were all independent risk factors for anastomotic fistula formation(P<0.05).Conclusion:Patients undergoing laparoscopic radical resection for rectal cancer have a certain risk of developing anastomotic fistula. Its occurrence is associated with multiple factors including gender, age, nutritional status, albumin levels at admission, concomitant diabetes, distance from the tumor margin to the anal margin, improper selection or use of surgical instruments during the procedure, and prophylactic stoma creation.更多还原