在早期胃癌的非治愈性内镜下膜剖析后,额外手术的危险因素
Feng Sun1, Yibo Huang2, Yan Sun3
1Division of Gastric Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
BMC gastroenterology
|November 10, 2023
概括
对于早期胃癌的非治愈性内镜下粘膜切割 (ESD) 后的手术干预是根据风险因素来指导的. 淋巴透需要额外的手术,而混合组织学类型需要单独考虑,因为转移风险很高.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 在瘤学瘤学.
背景情况:
- 对于早期胃癌的外科干预后非治愈性内镜下层剖析 (ESD) 的标准尚不清楚.
- 在非治愈性ESD后,确定残留癌症和淋巴结转移的风险因素至关重要.
- 需要制定额外手术的建议.
研究的目的:
- 为了澄清残留癌症和淋巴结转移的风险因素,在早期胃癌的非治愈性ESD后.
- 为这些患者提供额外的外科手术干预建议.
主要方法:
- 对133名患者进行回顾性分析,这些患者在早期胃癌的非治愈性ESD后接受了额外的手术.
- 从2013年1月到2022年7月在南京鼓楼医院收集的数据.
- 单变量和多变量分析以确定残留癌症和淋巴结转移的风险因素.
主要成果:
- 其余癌症的发生率为13.5%,淋巴结转移率为10.5%.
- 水平边缘阳性是残留癌症的独立风险因素.
- 淋巴透是淋巴结转移的一个独立风险因素.
- 混合组织学类型显示淋巴结转移的可能性更高,需要额外的手术.
结论:
- 强烈建议在非治愈性ESD后对淋巴透的患者进行额外的胃切除术与淋巴结解剖.
- 患有早期胃癌混合组织类型的患者具有淋巴结转移的高风险,应作为一个独特的亚型来管理.
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