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感染性并发症对胃癌复发的影响。

Impact of infectious complications on gastric cancer recurrence.

机构信息

Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.

出版信息

Gastric Cancer. 2015 Apr;18(2):368-74. doi: 10.1007/s10120-014-0361-3. Epub 2014 Mar 17.

Abstract

BACKGROUND

Postoperative infectious complications increase disease recurrence in colorectal cancer patients. We herein investigated the impact of infectious complications on gastric cancer recurrence after curative surgery.

METHODS

In total, 502 patients who underwent R0 resection for gastric cancer were reviewed. Patients were classified into those with infectious complications (IC group) and those without infectious complications (NO group). The risk factors for recurrence-free survival (RFS) were identified.

RESULTS

Infectious complications, which occurred in 52 patients (10.4%), included pneumonia, ileus with a systemic inflammatory reaction, anastomotic leakage, and intraperitoneal abscess. The overall 5-year RFS rate was 83% in the NO group and 58% in the IC group (p = 0.000). Multivariate analysis demonstrated that age, ASA score, stage, and infectious complications were significant predictors of RFS.

CONCLUSIONS

Infectious complications were a risk factor for gastric cancer recurrence. To avoid causing infectious complications, the surgical procedure, surgical strategy, and perioperative care should be carefully planned.

摘要

背景

术后感染并发症会增加结直肠癌患者的疾病复发率。我们在此研究了感染并发症对胃癌根治术后复发的影响。

方法

共回顾了 502 例接受 R0 切除术治疗的胃癌患者。患者分为发生感染并发症(IC 组)和未发生感染并发症(NO 组)。确定无复发生存(RFS)的危险因素。

结果

52 例(10.4%)患者发生感染并发症,包括肺炎、伴有全身炎症反应的肠梗阻、吻合口漏和腹腔脓肿。NO 组的总 5 年 RFS 率为 83%,IC 组为 58%(p=0.000)。多因素分析表明,年龄、ASA 评分、分期和感染并发症是 RFS 的显著预测因素。

结论

感染并发症是胃癌复发的危险因素。为避免发生感染并发症,应仔细计划手术程序、手术策略和围手术期护理。

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