Analysis Of Perioperative Effect Factors Of Laparoscopic Rectal Cancer Surgery

Objective:To explore the factors of laparoscopic rectal cancer surgery perioperative index and their significance.Methods:Collect the cases of laparoscopic rectal cancer surgery operated in oncology department of the first affiliated hospital of Kunming medical university during May 2013 to December 2015. Analyze the patients’ basic situation, postoperation short-time index and postoperative tumor pathologic characteristics.By comparison between groups, find out the single factor index by using the chi-square statistical analysis. The single factors with statistically significance will be analyzed by logistic regression method to exclude the confounding factors, then gets the independent statistically significant factors.Results:Of the 213 patients,the median operation time is 245 minutes, the median surgical blood loss is 50 ml, the median time of flatus is 3 days, the median postoperative hospital stay is 12 days, the median total cost is 33547.1 yuan, the median number of lymph node is 12, anastomotic leakage occurred in 12 cases (5.6%).Tumor location and surgical procedure are independent factors of operation time;Gender, irradiation and surgical procedure are independent factors of surgical blood loss;Surgical procedure and age are independent factors of postoperative flatus;Age is independent factors of postoperative hospital stay,age is independent factors of total cost of hospitalization;Irradiation and tumor maximum diameter are independent factors of the number of lymph nodes;Tumor location is independent factors of anastomotic leakage;Body mass index isn’t statistically significant with various relevant factors analysis in laparoscopic rectal surgery.Conclusions:1.Analysis classified by surgical resection:AR gets less blood loss, shorter operation time;AR+Stomy gets shorter postoperative flatus time;2.Analysis classified by tumor location:tumor located within 0-6cm from anal edge suffers a longer operation time;The rate of anastomotic leakage of tumor located within 7-12cm from anal edge is higher;3.Elderly patients gets a longer postoperative flatus time, longer postoperative hospital stay, higher hospital total cost;4.Male, irradiated cases suffers more surgical blood loss;5.Irradiated cases get less lymph nodes, bigger tumor maximum diameter cases get more lymph nodes.