Terp Fjederholt Kaare, Svendsen Lars Bo, Mortensen Frank Viborg
Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Denmark.
Department of Surgical Gastroenterology and Transplantation, Rigshospitalet, Denmark.
Am J Surg. 2017 Aug;214(2):293-298. doi: 10.1016/j.amjsurg.2017.01.022. Epub 2017 Feb 14.
To investigate the effect of blood transfusions on the risk of anastomotic leakage (AL) in patients with gastro-esophageal-junction (GEJ) cancer.
The incidence of GEJ cancer is increasing in the western world. Surgery is the curative treatment of choice. AL increases mortality and morbidity, and increases the risk cancer reoccurrence. In colo-rectal surgery a relation between AL and blood transfusions have been demonstrated.
The risk of AL in relation to blood transfusions was investigated in a cohort study. 253 consecutive patients undergoing surgery for GEJ cancer was included. Data was based on a prospective maintained database and analyzed using logistic regressions models adjusting for multiple confounders.
We found an increased risk of AL when blood was transfused OR: 3.47, (1.51; 7.99). This relation was consistent after adjustment for multiple confounders OR: 4.60, (1.29; 16.4). Increasing number of blood units did not increase risk of AL further.
We present data demonstrating a strong correlation between receiving blood transfusions and the risk of AL after surgery in GEJ cancers patients.
探讨输血对胃食管交界部（GEJ）癌患者吻合口漏（AL）风险的影响。
在西方世界，GEJ癌的发病率正在上升。手术是首选的治愈性治疗方法。AL会增加死亡率和发病率，并增加癌症复发的风险。在结直肠手术中，已证实AL与输血之间存在关联。
在一项队列研究中调查了与输血相关的AL风险。纳入了253例连续接受GEJ癌手术的患者。数据基于一个前瞻性维护的数据库，并使用调整了多个混杂因素的逻辑回归模型进行分析。
我们发现输血时AL风险增加，比值比（OR）：3.47，（1.51；7.99）。在调整多个混杂因素后，这种关系仍然一致，OR：4.60，（1.29；16.4）。输血单位数量增加并未进一步增加AL风险。
我们提供的数据表明，GEJ癌患者接受输血与术后AL风险之间存在密切相关性。
