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术前6分钟步行距离可准确预测肝胰胆管癌手术后的术后并发症。

Preoperative 6-minute walk distance accurately predicts postoperative complications after operations for hepato-pancreato-biliary cancer.

作者信息

Hayashi Kazuhiro, Yokoyama Yukihiro, Nakajima Hiroki, Nagino Masato, Inoue Takayuki, Nagaya Motoki, Hattori Keiko, Kadono Izumi, Ito Satoru, Nishida Yoshihiro

机构信息

Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.

Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Surgery. 2017 Feb;161(2):525-532. doi: 10.1016/j.surg.2016.08.002. Epub 2016 Sep 27.

Abstract

BACKGROUND

Operation for hepato-pancreato-biliary cancer is among the most invasive open abdominal operations, with a high postoperative morbidity and mortality rate. The purpose of the present study is to investigate whether a preoperative 6-minute walk distance can predict major postoperative complications after operation for hepato-pancreato-biliary diseases.

METHODS

A total of 81 participants who underwent pancreaticoduodenectomy, major hepatectomy with extrahepatic bile duct resection, or hepatopancreatoduodenectomy were included. The 6-minute walk distance was performed within 1 week before operation. Patients were categorized into 2 groups based on surgical complications: Clavien-Dindo grade <3 and Clavien-Dindo grade ≥3. Clinical differences between the 2 groups were analyzed. Multivariate logistic regression analysis was performed to identify risk factors for postoperative complications that were categorized as Clavien-Dindo grade ≥3.

RESULTS

The multiple logistic regression model revealed a significant correlation between major postoperative complications and preoperative low 6-minute walk distance, low body mass index, and major blood loss. In patients with 6-minute walk distance <400 m (1,312 feet), the Clavien-Dindo grade was considerably greater than patients with ≥400 m.

CONCLUSION

The 6-minute walk distance is useful in identifying patients with a greater chance of developing major postoperative complications after surgery for hepato-pancreato-biliary cancer.

摘要

背景

肝胰胆癌手术是侵入性最强的开放性腹部手术之一,术后发病率和死亡率很高。本研究的目的是调查术前6分钟步行距离是否可以预测肝胰胆疾病手术后的主要术后并发症。

方法

共纳入81例接受胰十二指肠切除术、肝外胆管切除的大肝切除术或肝胰十二指肠切除术的患者。术前1周内进行6分钟步行距离测试。根据手术并发症将患者分为两组:Clavien-Dindo分级<3级和Clavien-Dindo分级≥3级。分析两组之间的临床差异。进行多因素逻辑回归分析,以确定术后并发症(分类为Clavien-Dindo分级≥3级)的危险因素。

结果

多元逻辑回归模型显示,术后主要并发症与术前低6分钟步行距离、低体重指数和大量失血之间存在显著相关性。在6分钟步行距离<400米(1312英尺)的患者中,Clavien-Dindo分级明显高于步行距离≥400米的患者。

结论

6分钟步行距离有助于识别肝胰胆癌手术后发生主要术后并发症可能性较大的患者。

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