大动脉化是否真的会影响直肠癌手术后的静脉漏?
Yu-Hang Diao1, Jian Chen2, Yang Liu3
1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medicine
|July 12, 2024
概括
在直肠癌手术后,腹腔大动脉化 (AAC) 与道泄漏 (AL) 的增加有关. 然而,在多变量分析中,AAC并未被证明是AL或严重AL的独立预测因素.
科学领域:
- 血管外科 血管外科
- 胃肠道瘤学 胃肠道瘤学
- 放射学 放射学是一门学科.
背景情况:
- 静脉漏 (AL) 是直肠癌 (RC) 手术后的一种严重并发症,影响患者的治疗结果.
- 大动脉化,特别是腹部大动脉化 (AAC),越来越多地被认为是系统性动脉样硬化的标志物.
- 对AAC对AL等手术并发症的潜在影响仍然不完全理解.
研究的目的:
- 为了调查大动脉化和RC手术后AL的发生之间的关联.
- 确定AAC是否是AL和严重AL (C级) 的独立预测因素.
主要方法:
- 在2011年1月至2020年1月期间接受手术的2412名RC患者的回顾性分析.
- 术前计算机断层扫描 (CT) 扫描被用于评估腹腔大动脉化 (AAC),上半腹腔大动脉化和下半腹腔大动脉化.
- 使用后勤回归分析 (单变量和多变量) 来评估AAC和AL结果之间的关联.
主要成果:
- 关节炎的发生率为4.0% (97名患者),C级关节炎的发生率为1.9% (47名患者).
- 患有AL和C级AL的患者与没有AL的患者相比,AAC的患病率显著更高 (分别P=.019和P=.016).
- 单变量分析表明AAC是AL (OR=1.739) 和C等级AL (OR=2.339) 的重要因素. 然而,多变量分析并没有将AAC确定为两种结果的独立预测因子 (AL的P=.157,C级AL的P=.064).
结论:
- 在直肠癌手术后,腹腔大动脉化与解静脉泄漏的风险增加有关.
- 尽管存在这种关联,但在多变量分析中,AAC并不是道泄漏或严重道泄漏的独立预测因素.
- 可能需要进一步的研究来阐明血管化在手术并发症发展中的确切作用.
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