腹膜癌病对姑息性胃旁路术治疗恶性胃出口梗阻围手术期结局的影响 - 一项回顾性队列研究。
Influence of peritoneal carcinomatosis on perioperative outcome in palliative gastric bypass for malignant gastric outlet obstruction - a retrospective cohort study.
机构信息
Department of Surgery and Transplantation, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Department of Internal Medicine III, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
出版信息
World J Surg Oncol. 2020 Jan 31;18(1):25. doi: 10.1186/s12957-020-1803-5.
BACKGROUND
Malignant gastric outlet obstruction (GOO) is commonly associated with the presence of peritoneal carcinomatosis (PC) and preferably treated by surgical gastrojejunostomy (GJJ) in patients with good performance. Here, we aim to investigate the role of PC as a risk factor for perioperative morbidity and mortality in patients with GOO undergoing GJJ.
METHODS
Perioperative data of 72 patients with malignant GOO who underwent palliative GJJ at our institution between 2010 and 2019 were collected within an institutional database. To compare perioperative outcomes of patients with and without PC, extensive group analyses were carried out.
RESULTS
A set of 39 (54.2%) patients was histologically diagnosed with concomitant PC while the remaining 33 (45.8%) patients showed no clinical signs of PC. In-house mortality due to surgical complications was significantly higher in patients with PC (9/39, 23.1%) than in patients without PC (2/33, 6.1%, p = .046). Considerable differences were observed in terms of surgical complications such as anastomotic leakage rates (2.8% vs. 0%, p = .187), delayed gastric emptying (33.3% vs. 15.2%, p = .076), paralytic ileus (23.1% vs. 9.1%, p = .113), and pneumonia (17.9% vs. 12.1%, p = .493) without reaching the level of statistical significance.
CONCLUSIONS
PC is an important predictor of perioperative morbidity and mortality patients undergoing GJJ for malignant GOO.
背景
恶性胃出口梗阻（GOO）通常与腹膜癌病（PC）并存，对于一般状况良好的患者，最好通过手术胃空肠吻合术（GJJ）进行治疗。在此，我们旨在研究 PC 作为接受 GJJ 治疗的 GOO 患者围手术期发病率和死亡率的危险因素的作用。
方法
我们在机构数据库中收集了 2010 年至 2019 年间在我院接受姑息性 GJJ 的 72 例恶性 GOO 患者的围手术期数据。为了比较有和没有 PC 的患者的围手术期结果，我们进行了广泛的组分析。
结果
一组 39 例（54.2%）患者经组织学诊断为同时患有 PC，而其余 33 例（45.8%）患者无 PC 的临床迹象。患有 PC 的患者（9/39，23.1%）的院内死亡率明显高于没有 PC 的患者（2/33，6.1%，p=0.046）。在手术并发症方面，如吻合口漏发生率（2.8% vs. 0%，p=0.187）、胃排空延迟（33.3% vs. 15.2%，p=0.076）、麻痹性肠梗阻（23.1% vs. 9.1%，p=0.113）和肺炎（17.9% vs. 12.1%，p=0.493）等方面存在明显差异，但没有达到统计学意义。
结论
PC 是接受 GJJ 治疗恶性 GOO 患者围手术期发病率和死亡率的重要预测指标。
Zotero 插件