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结直肠癌手术患者中症状性静脉血栓栓塞的发生情况及预后

Occurrence and Prognosis of Symptomatic Venous Thromboembolism in Colorectal Cancer Surgery Patients.

作者信息

Kim Dae Sik, Park Keun-Myoung, Won Yong Sung, Kim Jang Yong, Lee Jin Kwon, Kim Jun Gi, Oh Seong Taek, Jung Sang Seol, Kang Won Kyung

机构信息

Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Vasc Specialist Int. 2014 Jun;30(2):49-55. doi: 10.5758/vsi.2014.30.2.49. Epub 2014 Jun 30.

Abstract

PURPOSE

Colorectal cancer (CRC) has a high risk for postoperative thromboembolic complications such as venous thromboembolism (VTE) compared to other surgical diseases, but the relationship between VTE and CRC in Asian patients remains poorly understood. The present study examined the incidence of symptomatic VTE in Korean patients who underwent surgery for CRC. We also identified risk factors, incidence and survival rate for VTE in these patients.

MATERIALS AND METHODS

The patients were identified from the CRC database treated from January 2011 to December 2012 in a single institution. These patients were classified into VTE and non-VTE groups, their demographic features were compared, and the factors which had significant effects on VTE and mortality between the two groups were analyzed.

RESULTS

We analyzed retrospectively a total of 840 patients and the incidence of VTE was 3.7% (31 patients) during the follow-up period (mean, 17.2 months). Histologic subtype (mucinous adenocarcinoma) and previous history of VTE affected the incidence of VTE on multivariate analysis. There was a statistically significant difference in survival rate between the VTE and non-VTE group, but VTE wasn't the factor affecting survival rate on multivariate analysis. Comparing differences in survival rate for each pathologic stage, there was only a significant difference in stage II patients.

CONCLUSION

Among CRC patients after surgery, the incidence of VTE was approximately 3% within 1 year and development of VTE wasn't a significant risk factor for death in our study but these findings are not conclusive due to our small sample size.

摘要

目的

与其他外科疾病相比,结直肠癌(CRC)术后发生静脉血栓栓塞(VTE)等血栓栓塞性并发症的风险较高,但亚洲患者中VTE与CRC之间的关系仍知之甚少。本研究调查了接受CRC手术的韩国患者中症状性VTE的发生率。我们还确定了这些患者VTE的危险因素、发生率和生存率。

材料与方法

从2011年1月至2012年12月在一家机构接受治疗的CRC数据库中识别出这些患者。将这些患者分为VTE组和非VTE组,比较他们的人口统计学特征,并分析两组之间对VTE和死亡率有显著影响的因素。

结果

我们回顾性分析了总共840例患者,随访期间VTE的发生率为3.7%(31例患者)(平均17.2个月)。多因素分析显示,组织学亚型(黏液腺癌)和既往VTE病史影响VTE的发生率。VTE组和非VTE组的生存率存在统计学显著差异,但多因素分析显示VTE不是影响生存率的因素。比较各病理阶段生存率的差异,仅II期患者存在显著差异。

结论

在CRC术后患者中,VTE的发生率在1年内约为3%,在我们的研究中VTE的发生不是死亡的显著危险因素,但由于样本量小,这些结果并不具有决定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a13/4480307/9cf1382efd4d/vsi-30-49f1.jpg

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