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术前无症状性肾功能障碍对食管癌手术后临床病程的影响。

Impact of pretreatment asymptomatic renal dysfunction on clinical course after esophagectomy.

机构信息

Department of Surgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

出版信息

Surg Today. 2021 Jan;51(1):165-171. doi: 10.1007/s00595-020-02118-z. Epub 2020 Aug 29.

Abstract

PURPOSE

Recent large-scale clinical studies have shown that preoperative renal insufficiency is associated with an increased risk of postoperative complications after esophagectomy; however, it remains unclear whether asymptomatic renal dysfunction affects the postoperative course after esophagectomy.

METHODS

The subjects of this retrospective study were 177 patients who underwent esophagectomy between May, 2009 and December, 2018. Renal function was evaluated based on the pretreatment estimated glomerular filtration rate (eGFR). Patients were divided into two groups according to the eGFR cut-off value of 55 ml/min per 1.73 m.

RESULTS

There were 17 patients in the low eGFR group and 160 patients in the normal group eGFR group. The rate of severe complications was significantly higher in the low eGFR than in the normal eGFR group. A low eGFR was the only significant complication risk factor identified; however, there were no marked differences in mortality or survival between the low and normal eGFR groups.

CONCLUSION

Our findings demonstrate that pretreatment asymptomatic renal dysfunction may be a significant risk factor for severe morbidity after esophagectomy.

摘要

目的

最近的大规模临床研究表明,术前肾功能不全与食管癌手术后并发症的风险增加有关;然而,无症状性肾功能障碍是否影响食管癌手术后的病程仍不清楚。

方法

本回顾性研究的对象为 2009 年 5 月至 2018 年 12 月期间接受食管癌切除术的 177 例患者。根据术前估算肾小球滤过率(eGFR)评估肾功能。根据 55ml/min/1.73m 的 eGFR 截止值将患者分为两组。

结果

低 eGFR 组有 17 例患者,正常 eGFR 组有 160 例患者。低 eGFR 组严重并发症发生率明显高于正常 eGFR 组。低 eGFR 是唯一确定的显著并发症危险因素;然而,低 eGFR 组和正常 eGFR 组之间的死亡率或生存率无明显差异。

结论

我们的研究结果表明,术前无症状性肾功能障碍可能是食管癌手术后严重发病率的一个重要危险因素。

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