穿孔胃癌的一阶段与两阶段胃切除术:系统性审查和元分析
Michele Manara1, Alberto Aiolfi1, Quan Wang2
1I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, Division of General Surgery, Department of Biomedical Science for Health, University of Milan, 20122 Milan, Italy.
Journal of clinical medicine
|July 12, 2025
概括
对于穿孔胃癌 (PGC),单阶段胃切除术 (1SG) 和双阶段胃切除术 (2SG) 显示的长期存活率相似. 两阶段胃切除术可能会降低中期死亡风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床流行病学临床流行病学
背景情况:
- 在紧急情况下对穿孔胃癌 (PGC) 的最佳手术管理进行了辩论.
- 一阶段胃切除术 (1SG) 和两阶段胃切除术 (2SG) 是建议的治疗策略.
- 对于PGC,比较1SG和2SG之间的结果至关重要.
研究的目的:
- 系统地审查和比较PGC的1SG与2SG的短期和长期结果.
- 进行个人患者数据 (IPD) 分析,以评估生存差异.
- 评估手术干预对死亡率的时间依赖性影响.
主要方法:
- 对PGC手术管理的回顾性研究的系统审查和IPD元分析.
- 包括来自579名患者的数据 (1SG中有482名,2SG中有97名).
- 使用概率比测试和危险函数图表评估时间依赖的影响.
主要成果:
- 观察到2SG的短期安全性和瘤治疗结果更好.
- 长期整体生存 (OS) 在1SG和2SG之间是可比的.
- 在手术后的前20个月内,发现1SG的死亡风险趋势较高.
结论:
- 1SG和2SG都在PGC管理中显示了可比的短期结果.
- 与1SG相比,2SG可能与中期死亡风险降低有关.
- 需要进一步的研究来完善PGC手术方法的临床决策.
相关概念视频
Peptic Ulcer Disease V: Surgical Management and Nursing Care
414
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
414
Esophageal Perforation-II: Clinical Manifestations and Management
151
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
151
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
301
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
301

