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影响胃癌患者术后并发症的因素:一项回顾性研究。

Factors influencing postoperative complications in patients with gastric cancer: A retrospective study.

作者信息

Xiao Ying, Ren Bang-Chun, Zhang Tao, Peng Dong, Min Jiang

机构信息

Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

World J Gastrointest Surg. 2025 May 27;17(5):101047. doi: 10.4240/wjgs.v17.i5.101047.

Abstract

BACKGROUND

Gastric cancer is a malignancy with high morbidity and mortality rates. Surgical intervention, particularly gastrectomy, is essential for curative treatment but carries a substantial risk of complications. Identifying key risk factors and understanding complication profiles are crucial for improving outcomes and guiding perioperative management.

AIM

To analyze the incidence of postoperative complications in patients with gastric cancer and identify potential risk factors.

METHODS

We conducted a retrospective analysis of 500 patients who underwent gastrectomy between January 2018 and December 2022. Postoperative complications were classified using the Clavien-Dindo system.

RESULTS

The overall complication rate was 28.4% (142/500), with 15.2% (76/500) experiencing major complications (Clavien-Dindo grade ≥ III). Pulmonary complications were the most frequent (10.8%), followed by surgical site infections (8.6%), and anastomotic leakage (4.2%). Age 70 years or more, body mass index of 25 kg/m² or more, advanced tumor stage, total gastrectomy, and operative time 240 min or more emerged as independent risk factors.

CONCLUSION

Focused preoperative risk assessment, targeted interventions, and reduced operative time for older or obese patients requiring total gastrectomy or presenting with advanced disease are important to improve surgical outcomes.

摘要

背景

胃癌是一种发病率和死亡率都很高的恶性肿瘤。手术干预,尤其是胃切除术,是根治性治疗的关键,但存在较高的并发症风险。识别关键风险因素并了解并发症情况对于改善治疗效果和指导围手术期管理至关重要。

目的

分析胃癌患者术后并发症的发生率,并识别潜在风险因素。

方法

我们对2018年1月至2022年12月期间接受胃切除术的500例患者进行了回顾性分析。术后并发症采用Clavien-Dindo系统进行分类。

结果

总体并发症发生率为28.4%(142/500),其中15.2%(76/500)发生了严重并发症(Clavien-Dindo分级≥Ⅲ级)。肺部并发症最为常见(10.8%),其次是手术部位感染(8.6%)和吻合口漏(4.2%)。年龄70岁及以上、体重指数25kg/m²及以上、肿瘤分期较晚、全胃切除术以及手术时间240分钟及以上被确定为独立风险因素。

结论

对于需要进行全胃切除术或患有晚期疾病的老年或肥胖患者,进行有针对性的术前风险评估、采取针对性干预措施并缩短手术时间对于改善手术效果非常重要。

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Gastric Cancer. 2021 Jan;24(1):1-21. doi: 10.1007/s10120-020-01042-y. Epub 2020 Feb 14.
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