同步的食道和肺切除是否会增加道泄漏的发生率? 一个多中心的回顾性研究
Yixin Liu1, Jianfeng Zhou1, Yimin Gu1,2
1Department of Thoracic Surgery, West China Hospital of Sichuan University.
International journal of surgery (London, England)
|January 5, 2024
概括
对于同步肺病变和食道癌 (CRLE) 的联合切除是可行的,但会增加解静脉泄漏的风险. 仔细的患者选择和手术规划至关重要,特别是在上叶解剖切除时,因为生存率下降的趋势.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 消化道癌研究 消化道癌研究
背景情况:
- 对同步肺病变和食道癌 (CRLE) 的联合切除很少报告,其可行性仍然存在争议.
- 现有的文献主要由个案报告组成.
研究的目的:
- 以回顾分析CRLE的可行性.
- 为了建立一个个性化的预测模型,以食道解性泄漏后CRLE.
- 为了比较单独的CRLE和食道切除术 (EA) 之间的结果.
主要方法:
- 一项多中心的回顾性研究将216例CRLE病例与EA患者进行了匹配,使用倾向性得分匹配 (1:2比).
- 使用多变量逻辑回归开发了一个名图,并通过Bootstrap重新抽样在内部验证.
- 卡普兰-梅尔曲线用于预后分析.
主要成果:
- 慢性脊髓炎显著增加了解静脉泄漏的发生率 (P=0.035).
- 解剖体泄漏与肺切除的类型 (解剖体与形,P=0.016) 和叶片部位 (上部与中部/下部,P=0.027) 有关.
- 一个名图预测泄漏的AUC为0.786.6. 综合上叶解剖切除与降低整体存活率有关 (P=0.027).
结论:
- 虽然CRLE是可行的,但它带有显著更高的解静脉泄漏的风险.
- 观察到总体存活率下降的趋势,特别是在上叶解剖切除时.
- 强调需要对CRLE进行细致的患者选择和手术规划.
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