新辅助放化疗对局部进展期直肠癌术后并发症及LARS发生影响因素分析

doi:10.3969/j.issn.1006-6233.2020.08.034

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摘要 目的: 研究新辅助放化疗对局部进展期直肠癌患者术后并发症与低位前切除综合征(low anterior resection syndrome, LARS)发生情况及影响因素。方法: 选取2015年3月至2018年6月我院确诊为直肠癌并进行新辅助放化疗与手术治疗患者115例作为研究对象, 根据患者情况将其分为未发生LARS组、发生LARS组, 分析两组患者术后并发症发生情况, 并对两组各基线资料进行分析, 采用单因素与多因素Logistic回归分析导致发生LARS的影响因素。结果: 115例患者中共46例发生LARS, 69例未发生。单因素显示:距手术完成时间、吻合口位置是导致LARS的可疑关联因素, 差异具有统计学意义(P<0.05)。多因素Logistic回归分析表明:距手术完成时间3~6个月、吻合口位置距离肛缘<5cm是关联危险因素, 差异具有统计学意义(P<0.05)。发生LARS与未发生者其他并发症发生率比较, 差异无统计学意义(P>0.05)。结论: 距离手术完成时间3~6个月、吻合口位置距离肛缘<5cm是导致新辅助化疗后局部进展期直肠癌患者发生LARS的影响因素。发生LARS与未发生者术后其他并发症发生率比较无显著差异。

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关键词 ：新辅助放化疗, 局部进展期, 直肠癌, 并发症, 影响因素

Abstract：Objective: To study the incidence of postoperative complications and low-order anterior resection syndrome (LASRS) in patients with locally advanced rectal cancer. Methods: From March 2015 to June 2018, 115 patients with rectal cancer diagnosed in our hospital and treated with neoadjuvant radiotherapy and chemotherapy and surgery were divided into no LARS group and LARS group according to the situation of the patients. The postoperative complications of the two groups were analyzed, and the baseline data of the two groups were analyzed. The influencing factors of LARS were analyzed by univariate and multivariate Logistic regression analysis. Results: Of the 115 patients, 46 had Lars, 69 had no Lars. Univariate analysis showed that the time from the completion of operation and the position of anastomotic stoma were the suspicious related factors of Lars, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that 3~6 months from the completion of the operation and less than 5cm from the anal margin were the related risk factors, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of other complications between patients with Lars and those without Lars (P>0.05). Conclusion: 3~6 months before operation and less than 5cm from anal margin were the influencing factors of Lars in locally advanced rectal cancer patients after neoadjuvant chemotherapy. There was no significant difference in the incidence of other complications between patients with Lars and those without Lars.

Key words： Neoadjuvant radiotherapy and chemotherapy Local progressive stage Rectal cancer Complications Influencing factors

基金资助:西京医院学科助推计划项目, (编号:XJZT18ML51)

通讯作者: 许曼

引用本文:

柴广金, 许曼, 许曼, 李围围, 许林林, 孙晓欢. 新辅助放化疗对局部进展期直肠癌术后并发症及LARS发生影响因素分析[J]. 河北医学, 2020, 26(8): 1380-1384.
CHAI Guangjin, XU Man, LI Weiwei, et al. Analysis of Effect of Neoadjuvant Radiotherapy and Chemotherapy on Postoperative Complications and LARS in Patients with Locally Advanced Rectal Cancer. HeBei Med, 2020, 26(8): 1380-1384.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.08.034 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I8/1380

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