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推迟手术后的长期结果,以优化患有急性右侧阻塞结肠癌的患者
Elize W Lockhorst1, Jeske R E Boeding1, Lissa Wullaert2
1Department of Surgery, Amphia Hospital, Breda, the Netherlands; Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
对右侧结肠癌的术前优化显著减少了术后并发症. 这种涉及营养和物理治疗的方法可以改善结果,但不会对长期生存率产生负面影响.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 阻断结肠癌是一个手术挑战,往往需要紧急干预.
- 右侧结肠癌的急性呈现与显著的发病率有关.
研究的目的:
- 为了比较急性右侧阻塞性结肠癌患者的瘤,发病率和死亡率结果.
- 评估手术前优化与急诊手术对患者结果的影响.
主要方法:
- 对62名患有右侧阻塞性结肠癌的患者的回顾性分析,这些患者在2013年至2020年期间接受了治疗.
- 患者被分为一个优化组 (手术前营养,物理治疗,减压) 和一个非优化组 (紧急手术).
- 包括无病生存率和死亡率在内的结果在手术后长达三年被跟踪.
主要成果:
- 优化组 (n=30) 与非优化组 (n=32,78%) 相比,术后并发症率显著降低 (50%).
- 在90天死亡率 (7%对13%) 或三年整体存活率 (43%对56%) 中,两组之间没有发现显著差异.
- 在非优化组 (22小时) 和优化组 (9.6天) 中,手术的中位时间显著缩短.
结论:
- 推迟手术以进行手术前优化,阻断右侧结肠癌导致90天并发症率降低.
- 术前优化似乎不会对长期生存产生负面影响.
- 需要使用更大的样本大小进行进一步的研究来证实这些发现.
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