解静脉泄漏三元组:手术前患者的特征,手术后的风险因素和术后的结果
Michael Calvin Cantrell1, Brian Celso1, Erin M Mobley1
1Department of Surgery, University of Florida College of Medicine, Jacksonville, FL, United States.
概括
贫血和药物病史是最小侵入性食道切除术 (MIE) 后的门泄漏 (AL) 的关键危险因素. 虽然AL影响住院和再入院,但它不会显著影响存活率或癌症复发.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
- 临床结果研究研究
背景情况:
- 解剖管泄漏 (AL) 是食道切除术后的一个重大并发症.
- 最少侵入性食道切除术 (MIE) 旨在减少手术致病率.
- 确定AL的术后风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定经过微侵袭性食道切除术 (MIE) 后发生的静脉疏通性泄漏 (AL) 的术后风险因素.
- 调查AL与癌症复发和整体存活率之间的关联.
- 在食道癌患者中确定AL预防的可修改因素.
主要方法:
- 来自第三级中心的电子健康记录的回顾性观察研究.
- 包括接受了食道癌的MIE患者 (2013年9月 - 2023年7月).
- 使用了倾向性得分匹配的逻辑回归和卡普兰-梅尔生存分析.
主要成果:
- 贫血和药物病史与AL显著相关 (分别P=.011和P=.022).
- AL与增加的医院并发症,住院时间长度和30天的再入院有关.
- AL没有显著影响30/90天死亡率,癌症复发或整体存活率.
结论:
- 解剖管泄漏 (AL) 是多因素的,手术前贫血和药物病史是显著的贡献者.
- 虽然AL影响短期的医院结果,但它似乎不会影响长期的癌症结果.
- 建议进行手术前优化,特别是纠正贫血,以最大限度地降低AL风险.
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