结直肠癌手术死亡原因分析

目的]进一步明确结直肠癌的手术死亡率,探讨结直肠癌手术死亡原因。方法]回顾中山大学肿瘤防治中心自1964年1月至2004年12月共41年间经手术治疗的结直肠癌患者4498例,并以1984年12月为界将病例分为A组(1964年1月～1984年12月)和B组(1985年1月～2004年12月)两组,分析手术死亡的主要原因。结果]全组病例手术死亡(术后30天内死亡)共62例,手术死亡率为1.38%,主要死亡原因为多器官功能衰竭(26例,占41.9%)、中毒性休克(9例,占14.5%)、急性肾功能衰竭(4例,占6.5%)、吻合口瘘(3例,占4.8%)。A组手术死亡率3.05%,B组为0.97%,两组主要死亡原因相似。结论]多器官功能衰竭、中毒性休克、急性肾功能衰竭、吻合口瘘等是结直肠癌手术死亡的主要原因。

An Analysis of the Causes of Postoperative Death in Patients with Colorectal Cancer

Purpose] To investigate postoperative mortality and the causes in colorectal cancer. Methods] Four thousand, four hundred and ninty-eight cases with colorectal cancer who received surgical treatment in Cancer Center, Sun Yat-sen University from January 1964 to November 2004 were reviewed. The cases were divided into 2 groups: group A (1964.1~1984.12) and group B(1985.1~2004.12). Causes of postoperative death was analysed.Results] Sixty-two patients died within 30 days after operation, with a postoperative mortality of 1.38%. Main causes of postoperative death were multiple organ failure(26 cases,41.9%),toxic shock(9 cases,14.5%), acute renal failure(4 cases,6.5%), and anastomotic leakage(3 cases,4.8%). Postoperative mortality was 3.05% in group A and 0.97% in group B. And main causes of postoperative death were similar in the two groups. Conclusion] Main causes of postoperative death in colorectal cancer were multiple organ failure, toxic shock, acute renal failure and anastomosis leak.