Objective: To investigate the causes and impacts of unplanned reoperations (UO) in patients underwent colorectal cancer surgery, and its effect on the length of hospital stays and hospitalization fees of these patients. Methods: we retrospectively analyzed the data of colorectal tumor patients underwent resection and UO from January 2014 to November 2017 in Cancer Hospital, Chinese Academy of Medical Sciences (CAMS). Student t tests, ANOVA analysis and chi-square test were used to compare the paired data and data of multiple groups, respectively. Results: There were 5 923 cases who underwent colorectal cancer surgery from 2014 to 2017. Among them, 75 cases further accepted UO, the incidence rate of UO was 1.27%. Among the 75 patients of UO, 60 were male and 15 were female, 21 patients underwent colonic operation and 54 patients underwent rectal operation. The average length of hospital stays were 25.8 days and the average hospitalization fees were 110 647.04 yuan. The gender construction, surgical site, average length of hospital stays and hospitalization fees of UO were significantly different from those of operative colorectal tumor patients during this period (all P<0.01). There were 40 patients underwent anastomotic fistula, 11 patients underwent stoma complications and 10 patients underwent bowel obstruction, respectively, which accounts for the three most common causes of UO after colorectal cancer surgery, and the total incidence was 81.3%. The interval of reoperation and the first operation significantly impacted the average length of hospital stays of UO patients (P=0.003), while marginally affected the hospitalization fees (P=0.847). Conclusions: UO are more possible to occur to the male patients who undergo rectal operation. The length of hospital stays and hospitalization fees of UO are significantly increased when compare to those of operative colorectal cancer patients. The time of reoperation significantly impacts the length of hospital stays but has little effect on the hospitalization fees of UO patients.
目的： 探讨结直肠肿瘤外科手术患者发生非计划再次手术的原因、影响因素，及其对患者住院时间和住院费用的影响。 方法： 回顾性分析2014年1月至2017年12月中国医学科学院肿瘤医院手术和非计划再次手术治疗的结直肠肿瘤住院患者的手术和住院资料。 结果： 结直肠肿瘤手术患者共5 923例，其中非计划再次手术75例，发生率为1.27%。非计划再次手术患者中，男60例，女15例；结肠手术21例，直肠手术54例；平均住院日为25.8 d，平均住院费用为110 647.04元。与同期全部结直肠肿瘤手术患者比较，性别构成、手术部位、平均住院日、住院费用差异有统计学意义(均P<0.01)。吻合口瘘、造口并发症和肠梗阻是结直肠肿瘤手术患者发生非计划再次手术的前3位主要原因，分别有40、11和10例患者，占81.3%。非计划再次手术患者的再次手术时间对患者的住院时间有明显影响(P＝0.003)，但对总住院费用无影响(P＝0.847)。 结论： 行直肠手术的男性患者在结直肠外科手术后更易发生非计划再次手术，非计划再次手术显著增加患者的住院时间和住院费用。再次手术时间对非计划再次手术患者的住院时间有显著影响，但对住院费用并无影响。.
Keywords: Colorectal neoplasms; Complications; Hospitalization fees; Length of stays; Surgery; Unplanned reoperation.