肺切除手术后与积极边际相关的因素
Hamza Rshaidat1, Gregory L Whitehorn2, Micaela Collins1
1Department of Surgery, Division of Esophageal and Thoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
Clinical lung cancer
|April 24, 2024
概括
与机器人或VATS方法相比,开放式肺癌手术与更高的积极利相关. 诸如较大的瘤和晚期等因素也会增加积极边际风险,影响患者的治疗结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 肺部病理学 肺部病理学
背景情况:
- 手术切除是非小细胞肺癌的主要治疗方法.
- 微创手术技术,如机器人和视频辅助胸腔镜手术 (VATS) 已经获得了突出地位.
- 了解影响边缘积极性的因素对于优化手术结果至关重要.
研究的目的:
- 为了研究与肺癌切除中的积极外科边缘相关的因素.
- 为了比较不同外科手术方法的边缘阳性率:机器人,VATS和开放手术.
主要方法:
- 使用国家癌症数据库 (2010-2019) 进行回顾性队列研究.
- 包括18岁及以上的患者,为非小细胞肺癌进行手术切除肺部.
- 用后勤回归分析人口统计,临床和结果变量 (30/90天死亡率,再接收) 的分析.
主要成果:
- 在226,884名患者中,4.2%的患者有积极的边际.
- 阳性边际与30天和90天死亡率和再入院率的增加相关.
- 与积极边缘相关的因素包括年龄较大,男性性别,开放切除,切除,更高的临床阶段,更大的瘤大小,状/腺状组织学和更高的并发症指数.
结论:
- 机器人切除和VATS切除之间没有显著的差异.
- 开放切除与较高的阳性边缘率有关.
- 瘤大小,临床阶段,组织学 (状/腺状),男性性别和切除独立增加了正边缘风险.
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