风险因素与最小侵入性艾佛·易斯食道切除术后未能进行救援有关
Andres Ramos-Fresnedo1, Erin M Mobley1, Keouna Pather1
1Department of Surgery, University of Florida, 655 8th Street S, Jacksonville, FL, 32209, USA.
高龄和心脏伴随性疾病增加了最小侵入性艾沃尔·易斯食道切除术 (MIE) 后救援失败 (FTR) 的风险. 术前优化和共享决策对于改善这些患者的结果至关重要.
科学领域:
- 手术瘤学手术瘤学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 最少侵入性艾佛·易斯食道切除术 (MIE) 是食道癌的标准手术.
- 被定义为术后并发症后死亡率的救助失败 (FTR) 是手术质量的关键指标.
- 在MIE后确定FTR的风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 调查在接受MIE的患者中,与未能救援 (FTR) 相关的临床因素.
- 为了确定预测FTR的特定患者特征,在这个复杂的程序后.
主要方法:
- 在2013年9月至2023年9月期间接受MIE的282名成年患者的回顾性分析.
- FTR定义为患有任何克拉维恩-丁多等级并发症的患者的死亡率.
- 进行了单变量和多变量逻辑回归分析,以确定相关因素.
主要成果:
- 138名患者 (49%) 经历并发症,11名 (4%) 经历FTR.
- 无变量分析显示,75岁以上的患者 (OR 3.98) 和心脏并发症患者 (OR 4.70) 的FTR几率更高.
- 多变量分析表明,在75岁以上 (OR 2.86) 和心脏并发症 (OR 3.75) 的情况下,FTR概率增加的趋势.
结论:
- 高龄 (≥75岁) 和心脏并发症是MIE后FTR的重要风险因素.
- 术前风险分层,优化和共享决策对于减轻术后发病率和死亡率至关重要.
- 需要进一步的研究来制定有针对性的策略,以减少FTR率并提高MIE后的生存率.
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