| 王力利,李 勇,万 顷.141例胃癌患者术后非计划内再次手术的临床分析[J].肿瘤学杂志,2015,21(5):365-368. |
| 141例胃癌患者术后非计划内再次手术的临床分析 |
| Clinical Analysis on 141 Gastric Cancer Patients with Unscheduled Reoperation |
| 投稿时间：2014-10-06 |
| DOI：10.11735/j.issn.1671-170X.2015.05.B003 |
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| 中文关键词: 胃肿瘤 外科手术 再次手术 危险因素 |
| 英文关键词:gastric neoplasms surgery reoperation risk factors |
| 基金项目:国家自然科学基金(81072033，81372580)；河北省自然科学基金(C2010000619) ；河北省普通高校强势特色学科资助项目(冀教高［2005］52)；河北省科技支撑项目（14277779D）；河北省卫生厅重大医学科研课题（zd2013040） |
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| 中文摘要: |
| 摘 要：［目的］ 通过对胃癌患者术后非计划内再次手术情况的分析，探寻各种与再手术相关的危险因素，减少胃癌术后的再手术率。［方法］ 11 616例胃癌患者行手术治疗，对其中行非计划内再手术的141例胃癌患者，统计分析基本信息、合并症、既往史、治疗情况及预后。［结果］ 本组病例再手术率为1.21%（141/11 616），再手术距初次手术的时间为（15.89±15.20）d。初次手术前合并糖尿病、贫血、低蛋白、有腹部手术史、围手术期输血、术中出血量≥400ml的患者再手术率升高；行近端胃大部切除或全胃切除的再手术率高于开胸贲门切除和远端胃大部切除的患者（均P<0.05）。性别、是否高龄（≥60岁）、是否合并心肺疾病、根治度、术中是否使用防黏连剂和吻合器与再手术率无关（均P>0.05）。导致再手术的最常见的并发症为消化道瘘。［结论］ 胃癌患者非计划再手术的危险因素有初次手术前合并糖尿病、贫血、低蛋白、有腹部手术史、输血、术中出血量大、近端胃大部切除或全胃切除等，根据危险因素进行预防性的处理可能降低非计划再手术率。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate various relevant risk factors on reoperation of gastric cancer patients and to reduce the rate of reoperation. ［Methods］ There were 11 616 cases with gastric cancer undergoing operation，among them，unscheduled reoperations were carried out in 141 cases. The basic information，complications，previous history，treatment and prognosis of reoperation patients were analyzed.［Results］ The incidence of reoperation was 1.21%(141/11 616). The average time between the initial operation and reoperation was (15.89±15.20)d. Patients with diabetes before initial operation，anemia，hypoproteinemia，or with abdominal surgery history，blood transfusion，or blood loss≥400ml in initial operation had high incidence of reoperation. The incidence of reoperation in the group of proximal gastrectomy or total gastrectomy was higher than that of patients with thoracic cardiectomy or distal gastrectomy(P<0.05). The incidence of reoperation was not related with gender，age，cardiopulmonary disease，degree of operation，adopting stapling technique or using anti-adhesion agentia in initial operation. Anastomotic leakage was the key factor for high incidence of reoperation in all complications. ［Conclusion］ Diabetes before initial operation，anemia，hypoproteinemia，abdominal surgery history，blood transfusion，or blood loss ≥400ml in initial operation are the risk factors of the incidence of reoperation. Reoperations more likely happen on patients who had proximal gastrectomy or total gastrectomy. Preventative management according to risk factors might decrease the incidence of unscheduled reoperation. |
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