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早期近端胃癌行双通道重建与全胃切除术的血液学和营养结局相似。

Similar hematologic and nutritional outcomes after proximal gastrectomy with double-tract reconstruction in comparison to total gastrectomy for early upper gastric cancer.

机构信息

Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.

Gastric Cancer Center, Yonsei Cancer Center, Seoul, South Korea.

出版信息

Surg Endosc. 2019 Jun;33(6):1757-1768. doi: 10.1007/s00464-018-6448-x. Epub 2018 Sep 10.

Abstract

BACKGROUND

Proximal gastrectomy offers theoretical benefits over total gastrectomy in terms of hematologic and nutritional outcomes. However, little evidence confirming these benefits has been reported. The aim of this study was to assess the hematologic and nutritional outcomes of proximal gastrectomy with double-tract reconstruction in comparison to those of total gastrectomy.

METHODS

We retrospectively analyzed data from 80 patients with stage I gastric cancer who underwent proximal gastrectomy with double-tract reconstruction (n = 38) or total gastrectomy (n = 42) from September 2014 to December 2015. We compared hematologic (including hemoglobin, ferritin, vitamin B, etc.) and nutritional outcomes [including body mass index (BMI), serum total protein, albumin, total cholesterol, and total lymphocyte count] between the two groups.

RESULTS

We found no significant differences in changes in hemoglobin (P = 0.250) or cumulative incidence of iron deficiency anemia (P = 0.971) during a median follow-up period of 24 months (range 18-30 months) after surgery. Cumulative incidence of vitamin B deficiency also did not differ significantly between the proximal and total gastrectomy groups (P = 0.087). BMI changes from baseline were not significantly different between the two groups (P = 0.591). Likewise, there were no statistically significant differences in nutritional outcomes.

CONCLUSIONS

Proximal gastrectomy with double-tract reconstruction exhibited similar outcomes in terms of hematologic and nutritional features in comparison to total gastrectomy.

摘要

背景

与全胃切除术相比,近端胃切除术在血液学和营养方面具有理论优势。然而,很少有证据证实这些益处。本研究旨在评估双道重建的近端胃切除术与全胃切除术的血液学和营养结局。

方法

我们回顾性分析了 2014 年 9 月至 2015 年 12 月期间 80 例 I 期胃癌患者的资料,这些患者接受了双道重建的近端胃切除术(n=38)或全胃切除术(n=42)。我们比较了两组之间的血液学(包括血红蛋白、铁蛋白、维生素 B 等)和营养状况[包括体重指数(BMI)、血清总蛋白、白蛋白、总胆固醇和总淋巴细胞计数]。

结果

在术后中位数为 24 个月(范围 18-30 个月)的随访期间,我们发现血红蛋白的变化(P=0.250)或缺铁性贫血的累积发生率(P=0.971)没有显著差异。近端胃切除术和全胃切除术组之间维生素 B 缺乏的累积发生率也没有显著差异(P=0.087)。BMI 从基线的变化在两组之间也没有显著差异(P=0.591)。同样,营养结局也没有统计学上的显著差异。

结论

与全胃切除术相比,双道重建的近端胃切除术在血液学和营养特征方面具有相似的结果。

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