Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
Medicina (Kaunas). 2022 Mar 25;58(4):474. doi: 10.3390/medicina58040474.
: Adenocarcinoma of the esophagogastric junction (AEG) has a complicated surgical anatomy, due to which it sometimes induces excessive intraoperative blood loss that necessitates intraoperative blood transfusion (BTF). However, few reports have focused on the impact of BTF on the survival outcomes of patients with AEG. We aimed to evaluate the impact of BTF on AEG prognosis. : We included 63 patients who underwent surgical resection for AEG at our hospital between January 2010 and September 2020. Clinicopathological characteristics and survival outcomes were compared between patients with ( = 12) and without ( = 51) BTF. Multivariate analysis was performed to identify the independent prognostic factors for overall survival. : None of the patients who underwent minimally invasive surgery received BTF. Patients who received BTF had a significantly worse 5-year survival rate than those who did not (67.8% vs. 28.3%, = 0.001). BTF was an independent risk factor for overall survival (hazard ratio: 3.90, 95% confidence interval 1.30-11.7), even after patients who underwent minimally invasive surgery were excluded. : BTF adversely affected the survival outcomes of patients with AEG who underwent curative surgery. To avoid BTF, surgeons should strive to minimize intraoperative bleeding.
胃食管结合部腺癌（AEG）的手术解剖结构复杂，这使得其有时会导致术中大量失血，需要术中输血（BTF）。然而，目前很少有研究关注 BTF 对 AEG 患者生存结局的影响。我们旨在评估 BTF 对 AEG 预后的影响。
我们纳入了 2010 年 1 月至 2020 年 9 月期间在我院接受手术切除的 63 例 AEG 患者。比较了有（=12 例）和无（=51 例）BTF 的患者的临床病理特征和生存结局。采用多因素分析确定总生存的独立预后因素。
接受微创手术的患者均未接受 BTF。接受 BTF 的患者 5 年生存率明显低于未接受 BTF 的患者（67.8% vs. 28.3%，=0.001）。即使排除接受微创手术的患者，BTF 也是总生存的独立危险因素（风险比：3.90，95%置信区间 1.30-11.7）。
BTF 会对接受根治性手术的 AEG 患者的生存结局产生不利影响。为了避免 BTF，外科医生应尽量减少术中出血。
