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利用日本全国性数据库的数据,研究严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染对胃肠癌手术后短期预后的影响。

Impact of SARS-CoV-2 infection on short-term postoperative outcomes after gastroenterological cancer surgery using data from a nationwide database in Japan.

作者信息

Takeuchi Masashi, Hibi Taizo, Seishima Ryo, Takemura Yusuke, Maeda Hiromichi, Toshima Genta, Ishida Noriyuki, Miyazaki Naoki, Taketomi Akinobu, Kakeji Yoshihiro, Seto Yasuyuki, Ueno Hideki, Mori Masaki, Shirabe Ken, Kitagawa Yuko

机构信息

Department of Surgery Keio University School of Medicine Shinjuku-ku Tokyo Japan.

Department of Pediatric Surgery and Transplantation Kumamoto University Graduate School of Medical Sciences Kumamoto Japan.

出版信息

Ann Gastroenterol Surg. 2024 May 1;8(5):942-951. doi: 10.1002/ags3.12812. eCollection 2024 Sep.

Abstract

BACKGROUND

Due to the coronavirus disease 2019 (COVID-19) pandemic, cancer screening, diagnosis, and treatment have changed. This study aimed to investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prior to gastroenterological cancer surgeries on postoperative complications using data from a nationwide database in Japan.

METHODS

Data on patients who underwent surgery for cancer including esophageal, gastric, colon, rectal, liver, and pancreatic cancer between July 1, 2019, and September 300, 2022, from real-world sources in Japan were analyzed. The association between preoperative SARS-CoV-2 infection and short-term postoperative outcomes was evaluated. A similar analysis stratified according to the interval from SARS-CoV-2 infection to surgery (<4 vs. >4 weeks) was conducted.

RESULTS

In total, 60 604 patients were analyzed, and 227 (0.4%) patients were diagnosed with SARS-CoV-2 infection preoperatively. The median interval from SARS-CoV-2 infection to surgery was 25 days. Patients diagnosed with SARS-CoV-2 infection preoperatively had a significantly higher incidence of pneumonia (odds ratio: 2.05; 95% confidence interval: 1.05-3.74;  = 0.036) than those not diagnosed with SARS-CoV-2 infection based on the exact logistic regression analysis adjusted for the characteristics of the patients. A similar finding was observed in patients who had SARS-CoV-2 infection <4 weeks before surgery.

CONCLUSIONS

Patients with a history of SARS-CoV-2 infection had a significantly higher incidence of pneumonia. This finding can be particularly valuable for countries that have implemented strict regulations in response to the COVID-19 pandemic and have lower SARS-CoV-2 infection-related mortality rates.

摘要

背景

由于2019年冠状病毒病(COVID-19)大流行,癌症筛查、诊断和治疗发生了变化。本研究旨在利用日本全国数据库的数据,调查胃肠癌手术前严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染对术后并发症的影响。

方法

分析了2019年7月1日至2022年9月30日期间来自日本真实世界来源的接受癌症手术(包括食管癌、胃癌、结肠癌、直肠癌、肝癌和胰腺癌)患者的数据。评估术前SARS-CoV-2感染与术后短期结局之间的关联。进行了一项类似的分析,根据从SARS-CoV-2感染到手术的间隔时间(<4周与>4周)进行分层。

结果

总共分析了60604例患者,其中227例(0.4%)患者术前被诊断为SARS-CoV-2感染。从SARS-CoV-2感染到手术的中位间隔时间为25天。根据针对患者特征进行调整的精确逻辑回归分析,术前被诊断为SARS-CoV-2感染的患者肺炎发生率显著高于未被诊断为SARS-CoV-2感染的患者(优势比:2.05;95%置信区间:1.05 - 3.74;P = 0.036)。在手术前<4周感染SARS-CoV-2的患者中也观察到了类似的结果。

结论

有SARS-CoV-2感染史的患者肺炎发生率显著更高。这一发现对于那些为应对COVID-19大流行而实施严格规定且SARS-CoV-2感染相关死亡率较低的国家可能特别有价值。

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