细胞减灭术和 HIPEC 对术中胃肠道壁厚度和患者结局的影响。
Impact of Cytoreductive Surgery and HIPEC on Intraoperative Gastrointestinal Wall Thickness and Patient Outcomes.
机构信息
Department of Surgery, St. George Hospital, Kogarah, NSW, Australia.
Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia.
出版信息
Anticancer Res. 2020 May;40(5):2865-2869. doi: 10.21873/anticanres.14262.
BACKGROUND
Cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) is associated with significant postoperative ileus (POI). This study examined intraoperative gastrointestinal wall thickness (GWT) and its association with patient outcomes.
PATIENTS AND METHODS
A prospective study of patients undergoing CRS and HIPEC. Proximal and distal small intestine GWT, before and after HIPEC were recorded.
RESULTS
Thirty-four patients (mean age=56.1 years, 61.8% female) were recruited. After HIPEC, the mean proximal (4.5 vs. 3.0 mm, p=0.03) and distal (4.3 vs. 3.4 mm, p<0.01) GWT were increased. Increased GWT was associated with prolonged operative time (10 vs. 8.5 h, p=0.03) and total length of stay (35.71 vs. 21.25 days, p=0.02). Postoperative ileus occurred in 23.5% of patients but differences between GWT groups did not reach significance (28.6% vs. 20%, p=0.56).
CONCLUSION
GWT increased significantly during CRS and HIPEC and is reflective of tissue trauma and oedema. This was associated with prolonged operative time, total length of stay and post-operative ileus.
背景
细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）与显著的术后肠梗阻（POI）有关。本研究检查了术中胃肠道壁厚度（GWT）及其与患者结局的关系。
患者和方法
对接受 CRS 和 HIPEC 的患者进行前瞻性研究。记录 HIPEC 前后近端和远端小肠 GWT。
结果
共招募了 34 名患者（平均年龄 56.1 岁，61.8%为女性）。HIPEC 后，近端（4.5 毫米比 3.0 毫米，p=0.03）和远端（4.3 毫米比 3.4 毫米，p<0.01）GWT 均增加。GWT 增加与手术时间延长（10 小时比 8.5 小时，p=0.03）和总住院时间延长（35.71 天比 21.25 天，p=0.02）相关。23.5%的患者发生术后肠梗阻，但 GWT 组之间的差异无统计学意义（28.6%比 20%，p=0.56）。
结论
在 CRS 和 HIPEC 过程中，GWT 显著增加，反映了组织创伤和水肿。这与手术时间延长、总住院时间和术后肠梗阻有关。
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