Jiang Zheng-Jie, Peng Xu-Dong, Wei Zheng-Qiang, Tang Gang
Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Surg. 2023 Sep 5;10:1184887. doi: 10.3389/fsurg.2023.1184887. eCollection 2023.
Given the rising prevalence of chronic liver disease (CLD), it is increasingly important to understand its impact on surgical outcomes. Our aim was to evaluate the impact of CLD on short-term outcomes in patients with colorectal cancer and synchronous liver metastases undergoing simultaneous surgery.
We retrospectively reviewed patients with colorectal cancer and liver metastases who underwent simultaneous resection between January 2013 and June 2022. Patients were divided into the CLD and non-CLD groups. Data regarding short-term surgical outcomes were compared between the two groups.
A total of 187 patients were included. After propensity score matching, there were 42 patients in each group, and the basic characteristics of the two groups were similar. Patients with CLD had a significantly greater incidence of postoperative complications (47.6% vs. 26.2%; = 0.042). The operation times of the CLD and non-CLD groups were similar (297 vs. 307.5 min, = 0.537), and the blood loss was comparable between the two groups (250 vs. 155 ml, = 0.066). No significant differences were observed between the two groups in pneumonia ( > 0.999), urinary infection rate ( > 0.999), ileus rate ( = 0.474), wound infection rates ( > 0.999), abdominal infection rate ( = 0.533), anastomotic leakage rate ( > 0.999), digestive hemorrhage rate ( > 0.999), bile leakage rate ( > 0.999), hepatic hemorrhage rate ( > 0.999), reoperation rate ( > 0.999), intensive care rate ( > 0.999), or severe liver failure ( > 0.999). There were no deaths in the two groups. CLD significantly prolonged the length of hospital stay ( = 0.011).
CLD is an important factor affecting postoperative complications in patients with colorectal cancer liver metastases undergoing simultaneous surgery. Considering the large number of patients with CLD in China, more attention and medical care should be provided to patients with CLD who require simultaneous resection of colorectal cancer with synchronous liver metastases.
鉴于慢性肝病（CLD）的患病率不断上升，了解其对手术结果的影响变得越来越重要。我们的目的是评估CLD对同时接受手术的结直肠癌和同步肝转移患者短期预后的影响。
我们回顾性分析了2013年1月至2022年6月期间同时接受结直肠癌和肝转移瘤切除的患者。患者分为CLD组和非CLD组。比较两组患者的短期手术预后数据。
共纳入187例患者。经过倾向评分匹配后，每组各有42例患者，两组的基本特征相似。CLD患者术后并发症的发生率显著更高（47.6%对26.2%；P = 0.042）。CLD组和非CLD组的手术时间相似（297对307.5分钟，P = 0.537），两组的失血量相当（250对155毫升，P = 0.066）。两组在肺炎（P>0.999）、泌尿系统感染率（P>0.999）、肠梗阻发生率（P = 0.474）、伤口感染率（P>0.999）、腹腔感染率（P = 0.533）、吻合口漏发生率（P>0.999）、消化道出血率（P>0.999）、胆漏发生率（P>0.999）、肝出血率（P>0.999）、再次手术率（P>0.999）、重症监护率（P>0.999）或严重肝衰竭（P>0.999）方面均未观察到显著差异。两组均无死亡病例。CLD显著延长了住院时间（P = 0.011）。
CLD是影响同时接受手术的结直肠癌肝转移患者术后并发症的重要因素。考虑到中国CLD患者数量众多，对于需要同时切除结直肠癌和同步肝转移瘤的CLD患者应给予更多关注和医疗护理。
