직장암의 저위전방 절제술 후 문합부 누출의 위험인자에 대한 분석
Risk Factors for Anastomotic Leakage after a Low Anterior Resection for Rectal Cancer
윤석준, 김진수, 민병소, 김남규, 백승혁, 이강영, 손승국, 조장환,
소속 상세정보
윤석준 ( Yoon Seok-Jun )
연세대학교 의과대학 외과학교실
김진수 ( Kim Jin-Soo )
연세대학교 의과대학 외과학교실
민병소 ( Min Byung-Soh )
연세대학교 의과대학 외과학교실
김남규 ( Kim Nam-Kyu )
연세대학교 의과대학 외과학교실
백승혁 ( Paik Seung-Hyuk )
연세대학교 의과대학 외과학교실
이강영 ( Rhee Kang-Young )
연세대학교 의과대학 외과학교실
손승국 ( Sohn Seung-Kook )
연세대학교 의과대학 외과학교실
조장환 ( Cho Jang-Hwan )
연세대학교 의과대학 외과학교실
KMID : 0356720070230050365
Abstract
Purpose: Clinical anastomotic leakage remains a major problem after a low anterior resection for rectal cancer, so indentifing risk factors influencing anastomotic leakage is important. The aim of this study was to assess the association between risk factors and anastomotic leakage.
Methods: One thousand two hundred eight patients underwent a primary resection for rectal cancer from June 1993 to March 2007. We used hospital records and the colorectal cancer registry to analyze retrospectively the case histories of those patients. The operations were performed using a low anterior resection with the double stapling method. All patients underwent a tumor-specific mesorectal excision. Of the total, thirty-eight patients showed anastomotic leakage. Univariate and multivariate analyses were performed to assess the risk factors affecting to the anastomotic leakage.
Results: The rate of anastomotic leakage was 3.2% (38 of 1,208 patients) with a mortality rate of 7.9% (3 of 38 patients). The overall mortality rate was 0.3% (3 of 1,208 patients). Males accounted for 28 of the 38 patients with leakage, and female accounted for the the account for the remnant 10. The mean age was 53.7 years (33∼74 years). The mean leakage day was 11.8th day (3∼37th day) after the operation, and the mean hospital day was 39.2 days (7∼131 days). The mean body mass index (BMI) was 22.7 kg/m2 (15.7∼30.8 kg/m2). The mean operation time was 230.5 minutes (90∼425 minutes), and the mean bleeding loss was 519.5 cc (0∼3,500 cc).
Conclusions: Significant risk factors for anastomotic leakage after primary resection for rectal cancer were the transfusion amount during surgery, a preliminary colostomy, and nodal stage.
키워드
직장암;문합부 누출;위험인자
Rectal neoplasms;Anastomotic leakage;Risk factors
원문 및 링크아웃 정보
등재저널 정보