食道切除术后的教科书结果:从一个大体积中心的回顾性研究
Molly Ryskov Mathiesen1, Thomas Baastrup Piper1, August Adelsten Olsen1
1Department of Surgery and Transplantation, Copenhagen University Hospital, Rigshospitalet, Denmark.
Surgery
|May 21, 2024
概括
在食道癌的食道切除术中达到教科书的结果,在45%的患者中见到,与更好的整体存活率有关. 这凸显了短期手术质量如何影响患者长期存活率.
科学领域:
- 手术质量测量手术质量测量
- 在瘤学瘤学.
- 胃肠道手术 胃肠道手术
背景情况:
- 教科书结果是食道癌症手术中的综合质量指标.
- 高体积中心对于评估外科手术质量至关重要.
- 了解影响教科书结果的因素对于改善患者护理至关重要.
研究的目的:
- 为了确定教科书结局食道切除术在高体积中心的速度.
- 调查教科书结果与患者存活率之间的关联.
- 分析对整体和无复发生存时间的影响.
主要方法:
- 在哥本哈根大学医院的一项回顾性单中心研究.
- 包括接受选择性治疗性食道切除术的胃食道结癌患者 (2016年11月 - 2021年12月).
- 使用卡普兰-梅尔曲线和考克斯回归来分析生存结果.
主要成果:
- 观察到的教科书结局率为45% (195/433名患者).
- 教科书结局与改善的整体存活率独立相关 (HR 0.67,P=.011).
- 平均整体存活期为教科书结局的57个月,而没有32个月;注意到改善无复发存活率的趋势 (HR0.74,P=.064).
结论:
- 这项研究确定了45%的食道切除术教科书结局率.
- 教科书的结果与提高整体存活率直接相关.
- 改善的短期手术结果与食道癌患者的更好的长期生存相关.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
56
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
56
Barrett Esophagus-II: Clinical Manifestations and Management
139
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
139
Esophageal Strictures-II: Clinical Features and Management
66
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
66
Endoscopic Procedures I: Esophagogastroduodenoscopy
101
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
101
Gastroesophageal Reflux Disease II: Clinical Features and Management
69
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
69
Esophageal Strictures-I: Introduction
83
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
83


