胃切除术后的无疾病生存率不受时代的坚持影响
Javier Ripollés-Melchor1, Ane Abad-Motos2, Ana León-Bretscher3
1Department of Anaesthesia and Critical Care. Infanta Leonor University Hospital, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Fluid Therapy and Hemodynamic Monitoring Working Group, Spanish Society of Anaesthesia and Critical Care, Madrid, Spain.
Anaesthesia, critical care & pain medicine
|November 1, 2025
概括
手术后改善恢复 (ERAS) 坚持并没有显著影响胃癌患者的长期无疾病生存率 (DFS). 预后主要取决于瘤阶段和患者因素,而不是外科手术期间的协议遵守.
科学领域:
- 在瘤学瘤学.
- 手术科学 手术科学
- 临床研究 临床研究
背景情况:
- 手术后增强恢复 (ERAS) 协议是胃癌手术的标准,改善了术后恢复.
- 遵守ERAS对长期瘤结果的影响仍在调查中.
研究的目的:
- 评估ERAS协议的遵守与胃癌治愈性胃切除术后的无疾病生存率 (DFS) 之间的关联.
主要方法:
- 一个潜在的POWER4队列的副研究,涉及368名接受选择性胃切除术的患者.
- 用22个组成部分测量ERAS遵守,并从定量和分类上分析.
- 无疾病生存率 (DFS) 是主要终点,使用卡普兰-梅尔估计和多变量考克斯模型进行分析.
主要成果:
- 更高的ERAS遵守率显示出改善DFS的趋势,但这在多变量分析中没有统计学意义.
- 瘤阶段,慢性病,ASA分数≥III和全胃切除术是预后的独立预测因素.
- 在ERAS遵守和长期DFS之间没有发现显著的关联.
结论:
- 在经过胃切除术的胃癌患者中,ERAS坚持并不是长期DFS的独立预测因素.
- 患者和瘤特征是长期瘤结果的主要驱动因素.
- 在外科手术期间遵守程序可能不会影响这些患者的最终预后.
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