在胃切除术中出现不良术后结果的预后因素
B O Stüben1, G A Plitzko2, L Stern2
1Department of General, Visceral and Transplant Surgery, Medical Centre University Duisburg-Essen, Essen, Germany.
Frontiers in surgery
|December 18, 2023
概括
紧急手术显著增加了胃切除术后的死亡风险,而全胃切除术和亚全胃切除术显示了可比的住院死亡率. 了解风险因素可以改善胃癌患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 外科胃肠道外科手术
- 临床流行病学 临床流行病学
背景情况:
- 胃癌是全球癌症死亡的主要原因之一.
- 优化术后结果需要了解风险因素.
- 这项研究比较了胃切除手术的术后结果.
研究的目的:
- 为了比较经过全肠切除术和次肠切除术后的直接术后结果.
- 确定影响胃切除后住院死亡率的风险因素.
- 为了分析外科手术结果的流行病学和外科手术期间的数据.
主要方法:
- 从2009年1月到2020年1月,对302名经历胃切除术的患者进行了回顾性分析.
- 包括流行病学和外科手术期间的数据.
- 单变量和多变量分析以确定住院死亡的风险因素.
主要成果:
- 选择性手术在全胃切除 (95%) 和部分胃切除 (85%) 均占主导地位.
- 亚总胃切除术需要的红细胞输血量比总胃切除术多 (p=0.039).
- 紧急手术,通常用于良性疾病,与较差的整体存活率 (HR2.68,p=0.003) 有显著的关联.
结论:
- 总体和次总体胃切除术的住院死亡率相似.
- 紧急外科干预被确定为术后死亡率增加的唯一显著风险因素.
- 研究结果强调了手术急诊对胃切除术后患者存活率的关键影响.
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