手术后感染性并发症对食道切除术后的长期预后的影响
Suguru Maruyama1, Katsutoshi Shoda1, Yoshihiko Kawaguchi1
1Department of Digestive Surgery, University of Yamanashi Hospital, Yamanashi, Japan.
World journal of surgery
|December 1, 2024
概括
手术后的传染性并发症显著恶化了食道切除术后食道癌患者的生存率. 然而,慢性阻塞性肺病 (COPD) 改变了肺炎的预后影响,这表明个性化风险评估至关重要.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
背景情况:
- 手术后并发症是食道癌不良瘤结果的潜在风险因素.
- 消化管切除术后这些并发症的预后意义仍在争论中.
- 慢性阻塞性肺病 (COPD) 是一个需要考虑的关键并发症.
研究的目的:
- 调查影响食道癌患者经食道切除术后术后并发症预后的因素.
- 在此背景下,专门研究慢性阻塞性肺病 (COPD) 的作用.
主要方法:
- 对254名连续接受食道切除术的食道癌患者 (2009-2021) 的回顾性分析.
- 评估术后并发症与长期生存结果 (总生存率和无复发生存率) 之间的关联.
- 专注于传染性并发症 (术后肺炎和静脉泄漏) 以及它们与COPD的相互作用.
主要成果:
- 传染性并发症 (IC) 与更糟糕的整体存活率 (OS) 和无复发存活率 (RFS) 显著相关 (p < 0.01).
- 没有其他并发症影响生存;临床病理学变量没有改变IC对预后的影响.
- 术后肺炎在非COPD患者中恶化了OS和RFS,但在COPD患者中没有恶化,并倾向于相互作用 (p=0.09).
结论:
- 传染性并发症显著影响食道癌症患者食道切除术后的长期结果.
- 术后肺炎对生存的预后影响受COPD存在的影响.
- 没有临床病理因素改变了传染性并发症对预后的整体影响.
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