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内镜切除胃胃肠间质瘤术后并发症的危险因素:多中心分析。

Risk factors for postoperative complications in endoscopic resection of gastric gastrointestinal stromal tumors: a multi-center analysis.

机构信息

Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.

Department of Gastroenterology, No.1 People's Hospital of Kunshan, Suzhou, China.

出版信息

Surg Endosc. 2023 Sep;37(9):6844-6851. doi: 10.1007/s00464-023-10177-9. Epub 2023 Jun 12.

Abstract

BACKGROUND

Endoscopic resection (ER) is widely used in treating gastric gastrointestinal stromal tumors (gGISTs); however, complications occur frequently after resection. We aimed to determine factors associated with postoperative complications for ER of gGISTs.

METHODS

This was a retrospective, multi-center, observational study. Consecutive patients who underwent ER of gGISTs at five institutes from January 2013 to December 2022 were analyzed. The risk factors for delayed bleeding and postoperative infection were assessed.

RESULTS

A total of 513 cases were finally analyzed. Of 513 patients, 27 (5.3%) had delayed bleeding and 69 (13.4%) had a postoperative infection. Multivariate analysis indicated that risk factors for delayed bleeding were long operative time (OR = 50.655; 95% CI, 13.777-186.252; P < 0.001) and severe intraoperative bleeding (OR = 4.731, 95% CI, 1.139-19.658; P = 0.032), and risk factors for postoperative infection were long operative time (OR = 13.749, 95% CI, 6.884-27.461; P < 0.001) and perforation (OR = 4.339, 95% CI, 2.178-8.644; P < 0.001).

CONCLUSIONS

Our study indicated the risk factors for postoperative complications in ER of gGISTs. Long operation time is a common risk factor for delayed bleeding and postoperative infection. Patients with these risk factors should be given careful observation postoperatively.

摘要

背景

内镜下切除术(ER)广泛用于治疗胃胃肠道间质瘤(gGIST);然而,切除后常发生并发症。我们旨在确定与 gGIST 的 ER 术后并发症相关的因素。

方法

这是一项回顾性、多中心、观察性研究。分析了 2013 年 1 月至 2022 年 12 月在五家机构接受 gGIST ER 的连续患者。评估了延迟性出血和术后感染的危险因素。

结果

共分析了 513 例病例。513 例患者中,27 例(5.3%)有延迟性出血,69 例(13.4%)有术后感染。多变量分析表明,延迟性出血的危险因素是手术时间长(OR=50.655;95%CI,13.777-186.252;P<0.001)和术中严重出血(OR=4.731,95%CI,1.139-19.658;P=0.032),术后感染的危险因素是手术时间长(OR=13.749,95%CI,6.884-27.461;P<0.001)和穿孔(OR=4.339,95%CI,2.178-8.644;P<0.001)。

结论

本研究表明 gGIST 的 ER 术后并发症的危险因素。手术时间长是延迟性出血和术后感染的常见危险因素。有这些危险因素的患者术后应给予密切观察。

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