在直肠癌手术后的功能障碍:长期观察性研究
Masanori Sando1, Kay Uehara1, Yuanying Li2
1Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Journal of the anus, rectum and colon
|July 27, 2023
概括
结直肠手术显著降低功能,并在三年内使慢性病 (CKD) 的风险翻倍. 女性性别和晚期瘤 (cT4) 是关键的危险因素,而不是尿功能障碍 (UD).
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
背景情况:
- 排尿功能障碍 (UD) 在直肠手术后很常见,但其与未来慢性病 (CKD) 的联系尚不清楚.
- 了解直肠切除后的长期功能趋势对于患者的治疗结果至关重要.
研究的目的:
- 为了研究直肠切除后的长期功能变化.
- 为了确定患慢性病 (CKD) 后直肠手术的风险因素.
主要方法:
- 在2006-2017年间,对接受直肠切除 (n=129) 和切除术 (n=127) 的患者进行了回顾性分析.
- 估计的淋巴细胞过率 (eGFR) 比率与基线相比计算;3年后的eGFR比率<0.75,定义为未来CKD的替代品.
- 用多变量分析来确定CKD的独立风险因素.
主要成果:
- 在1.5年和3年内,直肠切除队列的eGFR比率显著下降,相比于切除队列的eGFR比率显著下降.
- 手术前的CKD患病率在直肠组较低,但在手术后3年 (29.5%vs30.7%) 的患病率变得相似.
- 女性性别和cT4瘤阶段被确定为未来CKD的独立风险因素;UD不是一个重要的因素.
结论:
- 与切除术相比,直肠癌手术导致术后eGFR显著下降.
- 在直肠切除后的三年内,CKD的发病率增加了一倍以上.
- 女性性别和CT4瘤阶段,而不是尿功能障碍,是直肠手术后未来CKD的独立预测因素.
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