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目的 :探讨吻合口漏与直肠癌术后局部复发和生存率的关系。方法 :对 1978年～ 1996年行直肠癌前切除术的 814例患者进行随访 ,并对发生与未发生吻合口漏患者的预后进行了单因素和多因素分析。结果 :814例中 89例 (10 .9% )发生了吻合口漏。经过Kaplan Meier生存曲线分析 ,患者总体 5a局部复发率是 13.6 %。多因素分析显示吻合口漏是影响肿瘤局部复发的独立危险因素 (相对危险度为 1.7,P =0 .0 4 18) ,也是影响肿瘤相关生存率的独立危险因素 (相对危险度为 1.6 ,P =0 .0 172 )。结论 :吻合口漏是影响直肠癌患者术后局部复发率和肿瘤相关生存率的危险因素。
Objective: To investigate the relationship between anastomotic leakage and local recurrence and survival after rectal cancer surgery. Methods : A total of 814 patients undergoing anterior resection of rectal cancer from 1978 to 1996 were followed up. Univariate and multivariate analyses were performed on the prognosis of patients with and without anastomotic leakage. Results: Anastomotic leakage occurred in 89 of 814 patients (10.9%). After Kaplan Meier survival curve analysis, the overall 5-year local recurrence rate of patients was 13.6%. Multivariate analysis showed that anastomotic leakage was an independent risk factor for the local recurrence of the tumor (relative risk 1.7, P =0.04), and it was also an independent risk factor for tumor-related survival (relative risk 1.6, P =0 .0 172 ). Conclusion: Anastomotic leakage is a risk factor that influences the local recurrence rate and tumor-related survival rate in rectal cancer patients.