老年患者上腺切除术后的结果;倾向性得分与分析结果相匹配
Charlotte L Viëtor1,2, Inge S van Egmond1,2, Gaston J H Franssen1
1Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.
Updates in surgery
|December 6, 2024
概括
与年轻患者相比,接受上腺切除术的老年患者 (70岁以上) 的术后结果和并发症率相似. 年龄本身不应该阻止对上腺体群体的手术干预.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 老年医学 老年医学
背景情况:
- 越来越多地检测到上腺体,这在老年患者中造成了外科手术的困境,原因是虚弱和潜在的术后并发症.
- 对于患有上腺质量的老年患者的手术决定需要仔细考虑风险与益处.
研究的目的:
- 为了比较70岁及以上患者的上腺切除术的术后过程和并发症率,与年轻人队列相比.
- 为了评估晚年是否是对上腺切除术的禁忌.
主要方法:
- 在2000年至2020年间对接受上腺切除术的患者进行单中心回顾性研究.
- 77名老年患者 (≥70岁) 与77名年轻患者 (<70岁) 的倾向性得分匹配,基于荷尔蒙状况,恶性瘤,手术方法和手术年份.
- 对严重并发症的分析 (Clavien-Dindo ≥3),整体并发症率,住院时间和死亡率.
主要成果:
- 在老年患者和年轻患者之间,严重并发症 (9.1%与6.5%) 或整体并发症率 (44.2%与40.3%) 没有显著差异.
- 在两个年龄组中,住院时间和死亡率相似.
- 老年患者患心血管并发症的发病率较高 (6.7%与未指明,p=0.039).
结论:
- 70岁及以上患者的上腺切除术与术后的病程和并发症概况相关,与年轻患者相比较.
- 在老年人中,大多数术后并发症都是轻微的,死亡率最小.
- 高龄不应该成为考虑对上腺体进行切除术的障碍.
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