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时间(季节、手术开始时间、等待时间)对胃癌患者的影响

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer.

作者信息

Peng Dong, Zou Ying-Ying, Cheng Yu-Xi, Tao Wei, Zhang Wei

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Mar 29;14:1327-1333. doi: 10.2147/RMHP.S294141. eCollection 2021.

Abstract

PURPOSE

The purpose of the present study was to evaluate the effect of time (season, surgical starting time in the daytime, preoperative waiting time) on patients with gastric cancer.

METHODS

A retrospective collection of medical records of patients who underwent gastrectomy at a single clinical center from January 2013 to December 2018 was performed. Medical records were collected, and short-term outcomes and long-term survival were analyzed by different time groups.

RESULTS

A total of 586 patients were included in this study. In terms of surgical starting time, the midday group had a shorter operation time (p=0.017) but more complications (p=0.048) than the non-midday group. No significant difference was found based on the season of gastrectomy. The long preoperative waiting group had a shorter postoperative hospital stay than the short waiting group (p=0.026). No significant difference was found between the short-waiting group and long-waiting group in overall survival for all clinical stages. Age (p=0.040, HR=1.017, 95% CI=1.001-1.033), BMI (p<0.001, HR=0.879, 95% CI=0.844-0.953) and clinical stage (p<0.001, HR=2.053, 95% CI=1.619-2.603) were independent prognostic factors predicting overall survival; however, season of gastrectomy, surgical starting time and preoperative waiting time were not identified as independent prognostic factors.

CONCLUSION

Surgical starting time at the midday could cause more complications, and surgeons should be careful when the surgical starting time is midday.

摘要

目的

本研究旨在评估时间(季节、白天手术开始时间、术前等待时间)对胃癌患者的影响。

方法

回顾性收集2013年1月至2018年12月在单一临床中心接受胃切除术患者的病历。收集病历,并按不同时间组分析短期结局和长期生存情况。

结果

本研究共纳入586例患者。在手术开始时间方面,午间组手术时间较非午间组短(p=0.017),但并发症更多(p=0.048)。基于胃切除术季节未发现显著差异。术前等待时间长的组术后住院时间比等待时间短的组短(p=0.026)。在所有临床分期的总生存方面,短等待组和长等待组之间未发现显著差异。年龄(p=0.040,HR=1.017,95%CI=1.001-1.033)、BMI(p<0.001,HR=0.879,95%CI=0.844-0.953)和临床分期(p<0.001,HR=2.053,95%CI=1.619-2.603)是预测总生存的独立预后因素;然而,胃切除术季节、手术开始时间和术前等待时间未被确定为独立预后因素。

结论

午间进行手术开始时间可能导致更多并发症,手术开始时间为午间时外科医生应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eccc/8018433/bbb5cf69a7df/RMHP-14-1327-g0001.jpg

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