手术后并发症对胃癌存活率的影响
Ayato Obana1, Kenichi Iwasaki1, Tatsushi Suwa1
1Department of Surgery, Kashiwa Kousei General Hospital, Chiba, Japan.
胃癌手术后的术后并发症显著降低整体存活率,增加非癌症死亡,主要是肺炎. 预防并发症对于改善胃切除术后患者预后至关重要.
科学领域:
- 在瘤学瘤学.
- 外科手术的结果
- 公共卫生 公共卫生
背景情况:
- 胃癌的胃切除术后术后并发症的长期结果尚不清楚.
- 非癌症相关的死亡率是胃癌幸存者的一个重大问题.
研究的目的:
- 研究术后并发症对胃癌患者非癌症相关死亡率的影响.
- 为了确定胃切除术后生存的预测因素.
主要方法:
- 分析了一组236名经过治疗性胃切除术的胃癌患者.
- 用克拉维恩-丁多分级系统 (II级或更高) 分类并发症.
- 卡普兰-梅尔,日志等级测试和考克斯危险分析评估了生存率和预测因素.
主要成果:
- 妄想是最常见的并发症.
- 患有并发症的患者的整体存活率显著降低 (5年:51.6% vs. 73.6%,P <.001),但类似的无复发存活率.
- 非癌症死亡,特别是肺炎,在并发症组中较高. 降低存活率的独立预测因素包括高ASA得分,输血,开放性手术,男性性别,全胃切除术和先前的神经/精神疾病.
结论:
- 手术后并发症会对长期预后产生负面影响,降低整体存活率并增加非癌症死亡率.
- 预防肺部疾病和主动管理对于改善胃切除术后的结果至关重要.
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