胃癌患者的胃十二指肠穿孔：与化疗的关系及预后。

Gastroduodenal Perforation in Cancer Patients: Association with Chemotherapy and Prognosis.

机构信息

Instituto do Cancer, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 01246-000, Brazil.

出版信息

Med Sci (Basel). 2023 Mar 28;11(2):26. doi: 10.3390/medsci11020026.

DOI:10.3390/medsci11020026

PMID:37092495

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10123675/

Abstract

BACKGROUND

Gastroduodenal perforation stands out as one of the complications in cancer patients. Despite its high mortality, its characteristics are still poorly described. This study aimed to evaluate the characteristics and outcomes of cancer patients who had gastroduodenal perforation, and the influence of chemotherapy (CMT) in these cases.

METHOD

A retrospective analysis of patients who underwent emergency surgery with an intraoperative finding of gastroduodenal perforation. Patients who performed CMT within 60 days before perforation were considered as the CMT group.

RESULTS

Among 45 patients included, 16 (35.5%) were classified as the CMT group and the remaining 29 (64.5%) patients as the non-CMT group. There was no difference between the groups regarding sex, age, BMI, comorbidity, and laboratory exams. ECOG 2-3 was significantly more frequent in the CMT group (68.8% vs. 34.5% = 0.027). Major postoperative complications were similar between both groups (75% vs. 58.6%, = 0.272). The sepsis of abdominal focus was the main postoperative complication. The 30-day mortality was 55.6%, with no difference between non-CMT and CMT groups (62.5% vs. 51.7%, respectively; = 0.486). A multivariate analysis of risk factors showed that only an age of ≥65 years was related to 30-day mortality.

CONCLUSIONS

Patients with gastroduodenal perforation and oncologic treatment present high mortality, regardless of receiving recent CMT.

摘要

背景

胃十二指肠穿孔是癌症患者的并发症之一。尽管其死亡率较高，但特征仍描述不足。本研究旨在评估发生胃十二指肠穿孔的癌症患者的特征和结局，以及化疗（CMT）在这些情况下的影响。

方法

对接受急诊手术且术中发现胃十二指肠穿孔的患者进行回顾性分析。将在穿孔前 60 天内接受 CMT 的患者视为 CMT 组。

结果

45 例患者中，16 例（35.5%）被归类为 CMT 组，其余 29 例（64.5%）为非 CMT 组。两组间性别、年龄、BMI、合并症和实验室检查无差异。CMT 组 ECOG 2-3 评分显著更高（68.8%比 34.5%，=0.027）。两组间主要术后并发症相似（75%比 58.6%，=0.272）。腹腔焦点感染是主要的术后并发症。30 天死亡率为 55.6%，非 CMT 组和 CMT 组间无差异（分别为 62.5%和 51.7%，=0.486）。对危险因素的多变量分析显示，只有年龄≥65 岁与 30 天死亡率相关。