肥胖在左侧结肠癌手术中选择性地增加了手术风险:一项回顾性队列研究
Simon Xu1, Rathin Gosavi1,2, Yat Cheung Chung1
1Department of Colorectal Surgery, Monash Health, David Street, Dandenong, Melbourne, VIC, 3193, Australia.
International journal of colorectal disease
|August 25, 2025
概括
肥胖并没有增加结肠癌手术的整体风险. 然而,接受左侧切除术的肥胖患者面临更高的手术内并发症和重症监护室入院风险,这表明需要进行量身定制的风险评估.
科学领域:
- 大肠直肠手术
- 外科瘤学
- 肥胖药物
背景情况:
- 肥胖通常被认为是不良手术结果的危险因素.
- 这项研究调查了肥胖对结肠癌切除结果的独立影响.
- 这项研究还研究了这些影响是否因结肠癌的解剖位置而有所不同.
研究的目的:
- 确定肥胖 (BMI ≥30 kg/m2) 是否独立地影响结肠癌切除术和术后的结果.
- 评估肥胖对手术结果的影响是否因结肠切除的解剖部位而异.
主要方法:
- 在2015年至2022年接受结肠癌切除的737名患者的回顾性队列研究.
- 患者按BMI (≥30对<30 kg/ m2),急性 (可选/急性) 和解剖部位 (右/左侧) 分层.
- 多变量逻辑回归分析了手术中的并发症,严重的术后发病率,转换为开放手术,ICU入院和30天死亡率.
主要成果:
- 肥胖与整体手术后并发症,严重的术后发病率,转化率或30天死亡率的增加无关.
- 在选择性病例中,肥胖与更高的ICU入院相关 (aOR1. 82).
- 在新出现的病例中,肥胖与更多的手术后并发症有关 (aOR 2. 18).
- 与右侧切除不同的是,肥胖患者的左侧切除显示了手术内并发症的增加 (aOR 1. 89) 和ICU入院 (aOR 3. 17).
结论:
- 整体而言,肥胖似乎不是结肠癌手术不良结果的独立风险因素.
- 然而,肥胖与外科手术风险增加有关,特别是左侧结肠切除.
- 研究结果提倡对接受结肠癌手术的肥胖患者进行精细的手术规划和风险分层.
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