术后腹腔感染性并发症对根治性胃癌手术后癌症复发相关生存的不良影响。
Adverse impact of postoperative intra-abdominal infectious complications on cancer recurrence-related survival after curative gastric cancer surgery.
机构信息
Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan; Cancer Center, Shiga University of Medical Science Hospital, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
出版信息
Am J Surg. 2022 Sep;224(3):949-954. doi: 10.1016/j.amjsurg.2022.05.009. Epub 2022 May 16.
BACKGROUND
This study aimed to evaluate the impact of postoperative intra-abdominal infectious complications (PICs) on survival after surgery for gastric cancer.
METHODS
A total of 152 patients who underwent curative gastrectomy for gastric cancer were included. The effect of clinicopathological features and PICs on recurrence-free survival (RFS) and overall survival (OS) were investigated.
RESULTS
The median age was 67 years. The pathological stage was stage I (61), II (40), and III (51). Thirty-two patients (21.1%) had PICs: 9, pancreatic fistula; 14, anastomotic leakage; and 17, intra-abdominal abscess. The five-year RFS and OS rates were significantly lower in patients with PICs than in those without PICs (63.4 vs. 85.6%; p < 0.01 and 56.4 vs. 80.3%; p < 0.01, respectively). In multivariate analysis, intraoperative blood loss was an independent prognostic factor for PICs.
CONCLUSIONS
Patients with PICs had worse clinical outcomes. Reducing intraoperative bleeding may improve the prognosis of gastric cancer.
背景
本研究旨在评估胃癌手术后腹腔内感染并发症（PICs）对生存的影响。
方法
共纳入 152 例接受胃癌根治性胃切除术的患者。分析临床病理特征和 PICs 对无复发生存（RFS）和总生存（OS）的影响。
结果
患者的中位年龄为 67 岁。病理分期为Ⅰ期（61 例）、Ⅱ期（40 例）和Ⅲ期（51 例）。32 例（21.1%）患者发生 PICs：9 例胰瘘，14 例吻合口漏，17 例腹腔脓肿。有 PICs 的患者 5 年 RFS 和 OS 率明显低于无 PICs 的患者（63.4%比 85.6%；p<0.01 和 56.4%比 80.3%；p<0.01）。多因素分析显示，术中出血量是 PICs 的独立预后因素。
结论
发生 PICs 的患者临床结局较差。减少术中出血可能改善胃癌的预后。
Zotero 插件