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代谢综合征对结直肠癌手术短期结局的影响。

Impact of metabolic syndrome on the short-term outcomes of colorectal cancer surgery.

机构信息

Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Dis Colon Rectum. 2010 Feb;53(2):186-91. doi: 10.1007/DCR.0b013e3181bdbc32.

Abstract

PURPOSE

The purpose of this study was to determine the effects of metabolic syndrome on the short-term outcomes of colorectal cancer surgery.

METHODS

A prospective, observational study of colorectal cancer patients who underwent elective oncological resection was conducted between June 2007 and August 2008 at the Faculty of Medicine, Siriraj Hospital, Bangkok. Each patient received preoperative screening for metabolic syndrome using the criteria of the American Heart Association and the National Heart, Lung, and Blood Institute. Factors influencing 30-day postoperative morbidity and mortality were analyzed.

RESULTS

The study included 114 patients with colorectal cancer, with an average age of 61 years (range 29-91). Forty-two (36.8%) patients had metabolic syndrome. There was no significant difference in age, sex, tumor, or operative parameters between patients with or without metabolic syndrome. There was no postoperative mortality, and overall postoperative morbidity was 21.9%. Patients with metabolic syndrome had a higher rate of complications and a longer length of hospital stay than those without metabolic syndrome (40.5% vs 11.1%, P < .001 and 11.2 vs 8.1 day, P = .006, respectively). The presence of metabolic syndrome, tumor location, American Society of Anesthesiologists' score III, elevated blood pressure, and high triglycerides level were risk factors for postoperative complications in the univariate analysis; however, in the multivariate analysis, the presence of metabolic syndrome and rectal cancer surgery were the only 2 independent factors for the development of complications.

CONCLUSIONS

Patients with metabolic syndrome had a higher rate of postoperative complication and a longer length of hospital stay than patients without metabolic syndrome.

摘要

目的

本研究旨在探讨代谢综合征对结直肠癌手术短期结局的影响。

方法

本前瞻性观察性研究纳入 2007 年 6 月至 2008 年 8 月在曼谷诗里拉吉医院医学院行择期肿瘤切除术的结直肠癌患者。每位患者均接受美国心脏协会和美国国立心肺血液研究所标准的代谢综合征术前筛查。分析影响 30 天术后发病率和死亡率的因素。

结果

本研究共纳入 114 例结直肠癌患者,平均年龄 61 岁(29-91 岁)。42 例(36.8%)患者患有代谢综合征。代谢综合征患者与无代谢综合征患者在年龄、性别、肿瘤或手术参数方面无显著差异。无术后死亡,总术后发病率为 21.9%。代谢综合征患者的并发症发生率和住院时间长于无代谢综合征患者(40.5%比 11.1%,P <.001;11.2 天比 8.1 天,P =.006)。在单因素分析中,代谢综合征的存在、肿瘤位置、美国麻醉医师协会评分Ⅲ级、血压升高和高甘油三酯血症是术后并发症的危险因素;然而,在多因素分析中,代谢综合征的存在和直肠癌手术是并发症发生的唯一 2 个独立因素。

结论

与无代谢综合征患者相比,代谢综合征患者术后并发症发生率更高,住院时间更长。

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