结肠直肠癌患者接受选择性和紧急手术的比较结果:倾向性得分匹配队列研究
Kedareswar1, Reddy P Abhinaya2,3,4, Vishnu Prasad Nr1
1Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education &Research (JIPMER), Puducherry, India.
Journal of gastrointestinal cancer
|January 6, 2026
概括
紧急结肠直肠手术 (EMCRS) 与选择性结肠直肠手术 (ELCRS) 相比,与更糟糕的短期结果有关. 然而,长期存活率相似,表明晚期疾病,而不是紧急手术,对结直肠癌患者的长期结果产生影响.
科学领域:
- 在瘤学瘤学.
- 外科胃肠道外科手术
- 公共卫生 公共卫生
背景情况:
- 结肠直肠癌 (CRC) 是全球癌症死亡的主要原因.
- 由于阻塞或穿孔等并发症,大量的CRC患者需要紧急手术.
- 对应急和选择性结直肠手术的结果进行比较对于患者管理至关重要.
研究的目的:
- 为了比较紧急结直肠手术 (EMCRS) 与选择性结直肠手术 (ELCRS) 的短期和长期结果.
- 确定影响结直肠癌切除术患者结果的因素.
主要方法:
- 558名接受治愈性CRC切除术的患者进行了回顾性前性队列研究.
- 不包括转移性或息性病例.
- 1:1倾向性得分匹配 (PSM) 基于人口统计,瘤位置和阶段.
主要成果:
- 在PSM之前和之后,EMCRS组的短期发病率和死亡率显著增加.
- EMCRS与严重并发症,败血症和住院患者死亡率的增加有关.
- 在PSM后,EMCRS和ELCRS组之间长期无病生存 (DFS) 或总生存 (OS) 没有显著差异.
结论:
- 紧急结直肠手术与较差的短期结果有关.
- 在呈现时的晚期疾病,而不是手术的紧急性质,可能导致长期生存的差异.
- 改善查和术前优化可能会改善紧急结直肠手术患者的结果.
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