对于超低直肠癌的脊髓间切除术后的静脉泄漏是否会影响长期的结果? 一个回顾性观察性研究
Feifan Liu1,2, Bin Zhang2, Jianbin Xiang3
1Postgraduate Training Base of Jinzhou Medical University, the Characteristic Medical Center of PLA Rocket Force, Beijing, 100088, China.
Langenbeck's archives of surgery
|October 10, 2023
概括
对于超低直肠癌的膜间切除后的解静脉泄漏 (AL) 可以导致狭窄和非逆转性静脉口腔. 然而,长期来看,瘤和功能结果仍然不受影响.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 超低直肠癌 (uLRC) 需要复杂的外科手术方法,如间切除 (ISR).
- 截面泄漏 (AL) 是直肠手术后的一个已知的并发症,可能会影响患者的治疗结果.
- 对于LULRC的ISR后的AL的长期后果需要进一步调查.
研究的目的:
- 评估在超低直肠癌 (uLRC) 中的穿刺切除术 (ISR) 后的静脉泄漏 (AL) 和长期负面结果之间的关联.
- 评估AL对慢性狭窄形成的影响,口腔阻塞逆转率,以及瘤和功能结果.
主要方法:
- 在2011年6月至2022年1月期间,分析了一组236名接受ISR的患者,并对LULRC进行转向性静脉切开术.
- 主要结局是AL的长期临床后果的发生率.
- 癌症结局 (复发,生存) 和功能结果 (逆转后问卷) 均在平均随访时间分别为59个月和24个月后进行评估.
主要成果:
- 症状性AL发生在17.4%的患者中;严重的泄漏需要重新拉巴切除术是罕见的 (0.8%).
- AL显著增加了慢性狭窄的风险 (29.3%与8.7%) 和静脉口腔不逆转的风险 (34.1%与4.6%).
- 解剖分离加剧了这些并发症. 长期的瘤结果和功能结果在患有AL和没有AL的患者之间是可比的.
结论:
- 对LURC的ISR后,静脉泄漏是显著的并发症,主要影响慢性狭窄和静脉静脉阻塞逆转率.
- 严重的泄漏是罕见的,AL似乎不会影响长期的瘤控制或功能结果.
- 仔细选择患者和手术技术至关重要,以尽量减少AL及其后果.
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