【摘要】 目的探讨直肠癌患者保肛术后低位前切除综合征(LARS)的发生率、恢复情况及影响因素。方法选取2014年10月至2016年10月普外科就诊并确诊为直肠癌、均进行保肛根治术的患者128例临床资料进行回顾性研究。统计患者术后LARS发生情况,并经单因素分析及多因素Logistic回归方法,分析其影响因素。结果 128例患者中,发生LARS 41例(32.03%),其中LARS组和无LARS组在距手术完成时间、术前放疗、吻合口位置、骶尾骨间径方面比较差异有统计学意义(P<0.05,P<0.01);而两组性别、年龄、手术方式、肿瘤浸润程度、美国癌症联合委员会(AJCC)分期、骨盆各径线方面比较差异无统计学意义(P均>0.05);其中采用χ2检验分割法比较距手术完成不同时间的LARS发生率,显示距手术完成时间短的患者LARS发生率高于距手术完成长的患者(P<0.017)。经多因素Logistic回归分析,发现吻合口距离肛缘<5 cm、术前放疗及距手术时间<3个月是术后LARS发生的独立危险因素(P均<0.01)。结论 LARS是直肠癌患者术后常见的并发症,其影响因素较多;随着距手术时间的延长,LARS的发生率会有所降低。更多还原

【Abstract】 Objective To investigate the incidence,recovery and influencing factors of low anterior resection syndrome( LARS) in rectal cancer patients after anus preserving surgery. Methods A retrospective study was performed in 128 patients confirmed as rectal cancer from October 2014 to October 2016 and treated with anus-preserving radical resection.The incidence of LARS after surgery was observed,and the influencing factors were analyzed by single factor and multiple factor logistic regression analysis. Results Out of 128 patients,41( 32. 03%) had LARS. There were significant differences in the comparisons of term from surgery complete to current time( postoperative recovery time),preoperative radiotherapy,anastomotic position and interval between sacral and coccyx among LARS group and non-LARS group( P <0. 05,P < 0. 01). There were no significant differences in gender,age,operation mode,tumor infiltration,American Joint Committee on Cancer( AJCC) staging and pelvic diameters( all P > 0. 05). χ2 test segmentation showed that the incidence of LARS in patients with shorter postoperative recovery time was significantly higher than that in patients with longer postoperative recovery time( P < 0. 017). The multivariate logistic regression analysis showed that the anastomotic distance less than 5 cm,preoperative radiotherapy and postoperative recovery time less than 3 months were the independent risk factors of LARS( all P < 0. 01). Conclusions LARS is a common complication of patients with rectal cancer after operation and is influenced by a few factors. With the extension of postoperative recovery time,the incidence of LARS will be reduced.更多还原