周日手术与结肠直肠癌患者的短期结果有关
Kouki Imaoka1, Manabu Shimomura1, Minoru Hattori2
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
The Journal of surgical research
|February 2, 2024
概括
星期五的选择性结直肠癌手术可能会导致并发症增加和更长的住院时间,特别是对于结直肠癌患者. 这些发现表明,对于复杂的手术,要仔细考虑手术日.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床结果研究研究
背景情况:
- 周日对选择性手术结果的影响,称为"周日效应",是持续辩论的主题.
- 这项研究调查了选择性结肠直肠癌 (CRC) 手术当天与短期术后结果之间的关联.
研究的目的:
- 分析选择性结肠直肠癌手术日和患者结果之间的关系.
- 为了比较在周五进行的结直肠癌手术的短期术后结果,与其他周日进行的结直肠癌手术进行比较.
主要方法:
- 一个多中心的回顾性分析包括2574名患者,他们在2017年至2019年期间接受了针对结直肠癌 (CRC) 的初级结直肠切除术.
- 患者被分为两组:周五手术和非周五手术 (周一至周四).
- 倾向性得分匹配 (PSM) 用于比较两组之间的30天死亡率和术后结果.
主要成果:
- 虽然整体死亡率很低 (0.04%),但在星期五手术的直肠癌患者患病率较高 (Clavien-Dindo ≥3a) 和PSM后的消化系统并发症.
- 星期五的直肠癌手术也与术后住院时间的延长有关.
- 对于结肠癌,手术时间和血液损失在星期五略有增加,但在PSM后不具有临床意义.
结论:
- 选择性结肠直肠癌手术,特别是直肠癌,在周五进行,可能与术后发病率增加和更长的住院时间有关.
- 研究结果表明,考虑到需要先进的手术技术和技能,周中的一天可能是安排复杂结直肠癌手术的一个因素.
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