结直肠癌术后吻合口漏的影响因素研究进展
Advances in the Study of Influencing Factors for Anastomotic Leakage Following Colorectal Cancer Surgery
DOI: 10.12677/acm.2025.1561919, PDF,   
作者: 饶仕晗, 涂利文, 任 安, 刘骐源, 李俊昱, 李佳聪, 曾祥福*:赣南医科大学第一附属医院胃肠外科,江西 赣州
关键词: 吻合口漏结直肠癌影响因素Anastomotic Leakage Colorectal Cancer Influencing Factors
摘要: 吻合口漏是结直肠癌术后最棘手的并发症之一,对患者的死亡率、住院时长、再手术率、肿瘤复发率及长期生存率等等均有较大影响。常见的结直肠癌术后吻合口漏的影响因素包括术前放疗、术前营养、体质指数、性别、抗生素等等。了解结直肠癌术后吻合口漏的影响因素,可以帮助临床医生尽早发现并及时干预吻合口漏的发生和进展,这对促进患者术后恢复、提高患者生活质量、延长患者生命等均具有重要意义。本文简要对结直肠癌术后吻合口漏的相关影响因素进行综述,旨在了解相关影响因素,对医生临床工作提供帮助。
Abstract: Anastomotic leakage is one of the most difficult complications after colorectal cancer surgery, which has a great impact on the mortality rate, length of hospital stay, reoperation rate, tumor recurrence rate, and long-term survival rate. Common influencing factors of anastomotic leakage after colorectal cancer surgery include preoperative radiotherapy, preoperative nutrition, body mass index (BMI), gender, antibiotics, etc. Understanding the influencing factors of anastomotic leakage after colorectal cancer surgery can help clinicians detect and intervene in the occurrence and progression of anastomotic leakage as soon as possible, which is of great significance for promoting postoperative recovery, improving patients’ quality of life, and prolonging patients’ lives. This article briefly reviews the influencing factors of anastomotic leakage after colorectal cancer surgery, aiming to understand the relevant influencing factors and provide help for doctors’ clinical work.
文章引用:饶仕晗, 涂利文, 任安, 刘骐源, 李俊昱, 李佳聪, 曾祥福. 结直肠癌术后吻合口漏的影响因素研究进展[J]. 临床医学进展, 2025, 15(6): 1816-1821. https://doi.org/10.12677/acm.2025.1561919

参考文献

[1] Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R.L., Soerjomataram, I., et al. (2024) Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 74, 229-263. [Google Scholar] [CrossRef] [PubMed]
[2] 中国结直肠癌诊疗规范(2023版) [J]. 消化肿瘤杂志(电子版), 2023, 15(3): 177-206.
[3] Zhao, Y., Li, B., Sun, Y., Liu, Q., Cao, Q., Li, T., et al. (2022) Risk Factors and Preventive Measures for Anastomotic Leak in Colorectal Cancer. Technology in Cancer Research & Treatment, 21, 1-14. [Google Scholar] [CrossRef] [PubMed]
[4] Rahbari, N.N., Weitz, J., Hohenberger, W., Heald, R.J., Moran, B., Ulrich, A., et al. (2010) Definition and Grading of Anastomotic Leakage Following Anterior Resection of the Rectum: A Proposal by the International Study Group of Rectal Cancer. Surgery, 147, 339-351. [Google Scholar] [CrossRef] [PubMed]
[5] 中华医学会外科学分会结直肠外科学组. 中国直肠癌手术吻合口漏诊断、预防及处理专家共识(2019版) [J]. 中华胃肠外科杂志, 2019, 22(3): 201-206.
[6] Jiang, W., Wang, H., Zheng, J., Zhao, Y., Xu, S., Zhuo, S., et al. (2022) Post-Operative Anastomotic Leakage and Collagen Changes in Patients with Rectal Cancer Undergoing Neoadjuvant Chemotherapy vs Chemoradiotherapy. Gastroenterology Report, 10, goac058. [Google Scholar] [CrossRef] [PubMed]
[7] Jestin, P., Påhlman, L. and Gunnarsson, U. (2008) Risk Factors for Anastomotic Leakage after Rectal Cancer Surgery: A Case‐Control Study. Colorectal Disease, 10, 715-721. [Google Scholar] [CrossRef] [PubMed]
[8] Degiuli, M., Elmore, U., De Luca, R., De Nardi, P., Tomatis, M., Biondi, A., et al. (2021) Risk Factors for Anastomotic Leakage after Anterior Resection for Rectal Cancer (RALAR Study): A Nationwide Retrospective Study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group. Colorectal Disease, 24, 264-276. [Google Scholar] [CrossRef] [PubMed]
[9] Yu, X., Xu, L., Bin, Y., Yuan, Y., Tian, S., Cai, B., et al. (2022) Risk Factors of Anastomotic Leakage after Anterior Resection for Rectal Cancer Patients. Current Medical Science, 42, 1256-1266. [Google Scholar] [CrossRef] [PubMed]
[10] Bekki, T., Shimomura, M., Adachi, T., Miguchi, M., Ikeda, S., Yoshimitsu, M., et al. (2023) Predictive Factors Associated with Anastomotic Leakage after Resection of Rectal Cancer: A Multicenter Study with the Hiroshima Surgical Study Group of Clinical Oncology. Langenbecks Archives of Surgery, 408, Article No. 199. [Google Scholar] [CrossRef] [PubMed]
[11] Peeters, K.C.M.J., Tollenaar, R.A.E.M., Marijnen, C.A.M., Klein Kranenbarg, E., Steup, W.H., Wiggers, T., et al. (2005) Risk Factors for Anastomotic Failure after Total Mesorectal Excision of Rectal Cancer. Journal of British Surgery, 92, 211-216. [Google Scholar] [CrossRef] [PubMed]
[12] Peltrini, R., Carannante, F., Costa, G., Bianco, G., Garbarino, G.M., Canali, G., et al. (2022) Oncological Outcomes of Rectal Cancer Patients with Anastomotic Leakage: A Multicenter Case-Control Study. Frontiers in Surgery, 9, Article ID: 993650. [Google Scholar] [CrossRef] [PubMed]
[13] Shiwakoti, E., Song, J., Li, J., Wu, S. and Zhang, Z. (2020) Prediction Model for Anastomotic Leakage after Laparoscopic Rectal Cancer Resection. Journal of International Medical Research, 48, 1-11. [Google Scholar] [CrossRef] [PubMed]
[14] Kishiki, T., Kojima, K., Aso, N., Iioka, A., Wakamatsu, T., Kataoka, I., et al. (2022) Intraoperative Colonoscopy in Laparoscopic Rectal Cancer Surgery Reduces Anastomotic Leakage. Journal of the Anus, Rectum and Colon, 6, 159-167. [Google Scholar] [CrossRef] [PubMed]
[15] Yang, Y., Ding, F., Xu, T., Pan, Z., Zhuang, J., Liu, X., et al. (2023) Double-Stapled Anastomosis without “Dog-Ears” Reduces the Anastomotic Leakage in Laparoscopic Anterior Resection of Rectal Cancer: A Prospective, Randomized, Controlled Study. Frontiers in Surgery, 9, Article ID: 1003854. [Google Scholar] [CrossRef] [PubMed]
[16] Hüser, N., Michalski, C.W., Erkan, M., Schuster, T., Rosenberg, R., Kleeff, J., et al. (2008) Systematic Review and Meta-Analysis of the Role of Defunctioning Stoma in Low Rectal Cancer Surgery. Annals of Surgery, 248, 52-60. [Google Scholar] [CrossRef] [PubMed]
[17] He, J., He, M., Tang, J. and Wang, X. (2023) Anastomotic Leak Risk Factors Following Colon Cancer Resection: A Systematic Review and Meta-Analysis. Langenbecks Archives of Surgery, 408, Article No. 252. [Google Scholar] [CrossRef] [PubMed]
[18] Tsalikidis, C., Mitsala, A., Mentonis, V.I., Romanidis, K., Pappas-Gogos, G., Tsaroucha, A.K., et al. (2023) Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going? Current Oncology, 30, 3111-3137. [Google Scholar] [CrossRef] [PubMed]
[19] Zarnescu, E.C., Zarnescu, N.O. and Costea, R. (2021) Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery. Diagnostics, 11, Article No. 2382. [Google Scholar] [CrossRef] [PubMed]
[20] Schardey, H.M., Wirth, U., Strauss, T., Kasparek, M.S., Schneider, D. and Jauch, K.W. (2020) Prevention of Anastomotic Leak in Rectal Cancer Surgery with Local Antibiotic Decontamination: A Prospective, Randomized, Double-Blind, Placebo-Controlled Single Center Trial. International Journal of Colorectal Disease, 35, 847-857. [Google Scholar] [CrossRef] [PubMed]
[21] Yang, J., Chen, Q., Jindou, L. and Cheng, Y. (2020) The Influence of Anastomotic Leakage for Rectal Cancer Oncologic Outcome: A Systematic Review and Meta‐Analysis. Journal of Surgical Oncology, 121, 1283-1297. [Google Scholar] [CrossRef] [PubMed]
[22] Toyoshima, A., Nishizawa, T., Sunami, E., Akai, R., Amano, T., Yamashita, A., et al. (2020) Narrow Pelvic Inlet Plane Area and Obesity as Risk Factors for Anastomotic Leakage after Intersphincteric Resection. World Journal of Gastrointestinal Surgery, 12, 425-434. [Google Scholar] [CrossRef] [PubMed]
[23] Li, T., Huang, J., Lei, P., Yang, X., Chen, Z., Chen, P., et al. (2022) A Novel Nomogram for Anastomotic Leakage after Surgery for Rectal Cancer: A Retrospective Study. PeerJ, 10, e14437. [Google Scholar] [CrossRef] [PubMed]
[24] Greijdanus, N.G., Wienholts, K., Ubels, S., Talboom, K., Hannink, G., Wolthuis, A., et al. (2023) Stoma-Free Survival after Rectal Cancer Resection with Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort. Annals of Surgery, 278, 772-780. [Google Scholar] [CrossRef] [PubMed]
[25] Lee, C. and Park, I.J. (2024) Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes. The World Journal of Mens Health, 42, 304-320. [Google Scholar] [CrossRef] [PubMed]
[26] Chiarello, M.M., Fransvea, P., Cariati, M., Adams, N.J., Bianchi, V. and Brisinda, G. (2022) Anastomotic Leakage in Colorectal Cancer Surgery. Surgical Oncology, 40, Article ID: 101708. [Google Scholar] [CrossRef] [PubMed]