胃切除术后的早期重新手术:对发病率,死亡率和长期瘤结果的影响
Yonatan Lessing1, Tal Inbar-Weissman1, Ron Cohen1
1Department of General Surgery, Tel Aviv Sourasky Medical Center, The Gray Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
概括
胃切除术后的早期重新手术显著恶化了短期结果,但没有影响长期胃癌存活率. 瘤生物学和感染, 而不是重新手术本身, 是预后的关键因素.
科学领域:
- 外科瘤学
- 胃肠病学
- 临床结果研究
背景情况:
- 胃切除术是胃癌的重要治疗方法.
- 胃切除术后的早期重新手术表明严重的并发症.
- 早期重新手术的长期瘤影响尚不清楚.
研究的目的:
- 评估早期重新手术对胃腺癌切除术后的长期瘤结果的影响.
- 确定影响外科手术期间发病率,死亡率和辅助治疗的因素.
主要方法:
- 在466名胃腺癌患者的回顾性队列研究 (2012-2022年).
- 在住院期间或出院后90天内无计划地返回OR.
- 使用卡普兰-梅尔和考克斯回归的生存分析.
主要成果:
- 10. 3% 的患者需要提前重新手术,主要是因为门漏水或出血.
- 再次手术的患者短期结局明显较差 (并发症增加,入住ICU,90天死亡率).
- 早期重新手术与整体存活率或疾病复发没有独立关联.
结论:
- 早期的重新手术显著影响了手术前期的结果,但并没有影响长期的癌症预后.
- 瘤生物学和传染性并发症是生存和复发的主要决定因素.
- 需要重新手术的患者不应被认为长期癌症结果较差;专注于预防并发症和优化瘤护理至关重要.
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