發(fā)布時間：2019-04-23 13:56

【摘要】：目的 探討腹腔鏡胃癌根治性全胃切除術(shù)后外科并發(fā)癥的Clavien-Dindo分級情況及危險因素。方法 回顧性分析2008年1月~2015年12月我院281例胃中上部癌行腹腔鏡根治性全胃切除術(shù)的臨床資料,根據(jù)Clavien-Dindo分級系統(tǒng)分析術(shù)后外科并發(fā)癥的發(fā)生情況,并采用logistic回歸分析術(shù)后外科并發(fā)癥發(fā)生的危險因素。結(jié)果 發(fā)生外科并發(fā)癥29例,發(fā)生率10.3%(29/281),其中嚴(yán)重外科并發(fā)癥9例,發(fā)生率3.2%(9/281)。術(shù)后外科并發(fā)癥的Clavien-Dindo分級情況:Ⅰ級3例(1.1%),Ⅱ級17例(6.0%),Ⅲa級4例(1.4%),Ⅲb級2例(0.7%),Ⅳ級2例(0.7%),Ⅴ級1例(0.4%)。單因素分析結(jié)果顯示患者年齡、BMI、手術(shù)時間、術(shù)中出血量、腫瘤分化、腫瘤大小、浸潤深度有統(tǒng)計學(xué)差異(P0.05)。logistic多因素分析表明年齡(OR=2.671,95%CI:1.138~6.269,P=0.024)、BMI(OR=4.970,95%CI:1.597~15.465,P=0.006)、腫瘤大小(OR=3.311,95%CI:1.068~10.260,P=0.038)、浸潤深度(OR=4.472,95%CI:1.120~17.862,P=0.034)和術(shù)中出血量(OR=3.835,95%CI:1.481~9.928,P=0.006)是腹腔鏡胃癌根治性全胃切除術(shù)后外科并發(fā)癥發(fā)生的獨立危險因素。多因素logistic回歸模型預(yù)測患者術(shù)后外科并發(fā)癥發(fā)生的受試者工作特征(reciever operating characteristic,ROC)曲線下面積是0.784(0.695~0.873)。結(jié)論 腹腔鏡胃癌根治性全胃切除術(shù)后外科并發(fā)癥的Clavien-Dindo分級以Ⅱ級較多見;患者年齡≥65歲、BMI≥25、腫瘤大小≥50 mm、浸潤深度≥T3及術(shù)中出血量≥100 ml應(yīng)警惕外科并發(fā)癥的發(fā)生。
[Abstract]:Objective to investigate the Clavien-Dindo grading and risk factors of surgical complications after radical gastrectomy for laparoscopic gastric cancer. Methods from January 2008 to December 2015, the clinical data of 281 cases of middle and upper gastric cancer undergoing laparoscopic radical total gastrectomy were retrospectively analyzed. According to the Clavien-Dindo grading system, the incidence of postoperative complications was analyzed. Logistic regression was used to analyze the risk factors of postoperative complications. Results Surgical complications occurred in 29 cases (10.3%), including 9 cases of severe surgical complications (3.2%). The Clavien-Dindo grading of surgical complications: grade 鈪，

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