Hasselgren K, Sandström P, Gasslander T, Björnsson B
Department of Surgery, Linköping University, Linköping, Sweden Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Department of Surgery, Linköping University, Linköping, Sweden Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Scand J Surg. 2016 Sep;105(3):147-52. doi: 10.1177/1457496915622128. Epub 2016 Feb 29.
BACKGROUND/AIM: Multivisceral resection for advanced tumors can result in prolonged survival but may also increase the risk of postoperative morbidity and mortality. The primary aim of this study was to investigate whether extensive resections increase the severity of postoperative complications.
A retrospective study was conducted between 2009 and 2014 at the Linköping University Hospital surgical department. All patients with a confirmed or presumed malignant disease who underwent a non-standardized surgical procedure requiring a multivisceral resection were included. The primary endpoint was 90-day complications according to the Clavien-Dindo score.
Forty-eight patients were included, with an age range of 17-77 years. A median of three organs was resected. The most common diagnoses were neuroendocrine tumor (n = 8), gastric cancer (n = 7), and gastrointestinal stromal tumor (n = 6). One patient died during surgery. Complications ⩾ grade 3b according to Clavien-Dindo score occurred in 10 patients. R0 resection was achieved in 32 patients. No correlation was observed between the number of anastomoses, perioperative blood loss, operative time, and complications. Only postoperative blood transfusion was correlated with severe complications (p = 0.046); however, a tendency toward more complications with an increasing number of resected organs was observed (p = 0.06).
Multivisceral resection can result in R0, potentially curing patients with advanced tumors. Here, no correlation between extensive resections and complications was observed. Only postoperative blood transfusion was correlated with severe complications.
背景/目的：对晚期肿瘤进行多脏器切除术可延长生存期，但也可能增加术后发病和死亡风险。本研究的主要目的是调查广泛切除是否会增加术后并发症的严重程度。
2009年至2014年在林雪平大学医院外科进行了一项回顾性研究。纳入所有确诊或疑似恶性疾病且接受了需要多脏器切除的非标准化手术的患者。主要终点是根据Clavien-Dindo评分的90天并发症。
纳入48例患者，年龄范围为17至77岁。中位切除三个器官。最常见的诊断为神经内分泌肿瘤（n = 8）、胃癌（n = 7）和胃肠道间质瘤（n = 6）。1例患者在手术期间死亡。根据Clavien-Dindo评分，≥3b级并发症发生在10例患者中。32例患者实现了R0切除。未观察到吻合口数量、围手术期失血量、手术时间与并发症之间的相关性。仅术后输血与严重并发症相关（p = 0.046）；然而，观察到随着切除器官数量增加并发症有增多趋势（p = 0.06）。
多脏器切除可实现R0切除，有可能治愈晚期肿瘤患者。在此研究中，未观察到广泛切除与并发症之间的相关性。仅术后输血与严重并发症相关。
