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[术前贫血及围手术期输血对直肠癌手术治疗的预后价值]

[Prognostic Value of Preoperative Anaemia and Perioperative Blood Transfusion in Surgical Treatment of Rectal Cancer].

作者信息

Kröpil F, Nestler T, Toeruen M, Fluegen G, Kraus S, Krieg A, Rehders A, Vallböhmer D, Knoefel W T

机构信息

Chirurgische Klinik (A), Heinrich-Heine-Universität und Universitätsklinikum Düsseldorf, Deutschland.

出版信息

Zentralbl Chir. 2015 Dec;140(6):640-4. doi: 10.1055/s-0033-1350887. Epub 2013 Dec 10.

Abstract

INTRODUCTION

There is evidence for the prognostic value of perioperative blood transfusion in the surgical treatment of patients with rectal cancer in the current literature. Also preoperative anaemia seems to have an impact on the outcome of these patients. The aim of this study was to evaluate the impact of preoperative anaemia and perioperative blood transfusion in patients with rectal cancer treated in our hospital.

PATIENTS AND METHODS

208 patients (81 females, 127 males; median age, 67 years) with rectal cancer were included in this retrospective study. All patients received surgical treatment. In 75 % of the patients an anterior rectum resection was performed while 25 % received an abdominoperineal rectum exstirpation. Patients with neoadjuvant treatment were included and statistical analyses were performed.

RESULTS

107 (51.4 %) patients exhibited preoperative anaemia. Patients with neoadjuvant treatment presented with significantly lower preoperative Hb (haemoglobin) values than patients without neoadjuvant treatment (p = 0.022). Patients with preoperative anaemia received significantly more blood transfusions (p = 0.001), had significantly longer hospital stays (p = 0.023) and significantly lower 5-years overall survival (p = 0.005). Blood transfusion was necessary in 82 patients (39.4 %). These patients presented with a significantly higher rate of perioperative complications (p = 0.01) and a lower 5-years overall survival (p = 0.002). In multivariate analyses neither preoperative anaemia nor perioperative transfusion was a significant prognostic factor.

CONCLUSION

In our study preoperative anaemia and perioperative blood transfusion seems to have an impact on outcome of surgical treatment of patients with rectal cancer. However, in multivariate analyses neither preoperative anaemia nor perioperative transfusion was a significant prognostic factor.

摘要

引言

当前文献中有证据表明围手术期输血对直肠癌患者手术治疗具有预后价值。此外,术前贫血似乎也会对这些患者的治疗结果产生影响。本研究的目的是评估我院治疗的直肠癌患者术前贫血和围手术期输血的影响。

患者与方法

本回顾性研究纳入了208例直肠癌患者(81例女性,127例男性;中位年龄67岁)。所有患者均接受了手术治疗。75%的患者进行了直肠前切除术,25%的患者接受了腹会阴直肠切除术。纳入接受新辅助治疗的患者并进行统计分析。

结果

107例(51.4%)患者存在术前贫血。接受新辅助治疗的患者术前血红蛋白(Hb)值显著低于未接受新辅助治疗的患者(p = 0.022)。术前贫血患者接受输血的次数显著更多(p = 0.001),住院时间显著更长(p = 0.023),5年总生存率显著更低(p = 0.005)。82例(39.4%)患者需要输血。这些患者围手术期并发症发生率显著更高(p = 0.01),5年总生存率更低(p = 0.002)。多因素分析显示,术前贫血和围手术期输血均不是显著的预后因素。

结论

在我们的研究中,术前贫血和围手术期输血似乎会对直肠癌患者手术治疗的结果产生影响。然而,多因素分析显示,术前贫血和围手术期输血均不是显著的预后因素。

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