在接受结直肠癌手术的老年患者和高风险患者的社区预康复
Lennaert Cb Groen1, Tess van Gestel1, Freek Daams2
1Department of Surgery, Northwest Clinics, Alkmaar, NL, the Netherlands.
概括
预康复显著减少了手术后并发症,并改善了接受手术的老年人和高风险结直肠癌患者的功能结果. 这种干预增强了康复,减少了再接收.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 手术瘤学手术瘤学
背景情况:
- 结肠直肠癌 (CRC) 手术存在风险,特别是对于老年患者 (≥70岁) 或具有高美国麻醉学会 (ASA) 评分 (3-4) 的患者.
- 预康复干预措施在缓解手术并发症和改善这些脆弱患者群体的功能恢复方面表现有前途.
研究的目的:
- 评估多模式预康复对老年和高危CRC患者术后并发症和功能结果的影响.
- 为了比较接受预康复和历史对照组的CRC患者之间的并发症率,停留时间,再入院和死亡率.
主要方法:
- 一项队列研究比较了50名接受预康复治疗的CRC患者 (≥70岁或ASA3-4岁) 与50名从历史队列中没有接受预康复治疗的类似患者.
- 主要结局是90天的术后并发症率,次要结局包括停留时间,再入院,死亡率和功能状态.
主要成果:
- 预康复患者经历的术后并发症率显著降低 (32.7%vs. 58%,p=0.015) 和零再入院,而对照组的再入院率为12.0% (p=0.012).
- 没有观察到停留时间或死亡率的显著差异.
- 与基线相比,在预康复组的术后六周,功能结局明显改善.
结论:
- 多模式预康复疗法有效地减少术后并发症,并增强接受结直肠癌手术的老年和高风险患者的短期功能恢复.
- 需要进一步的研究,以探索生活方式变化的长期可持续性和个性化预康复计划的有效性.
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