Crucitti F, Doglietto G B, Viola G, Frontera D, De Cosmo G, Sgadari A, Vicari D, Rizzi A
Department of Surgery, Catholic University School of Medicine, Rome, Italy.
World J Surg. 1998 Mar;22(3):241-7. doi: 10.1007/s002689900377.
A series of 101 consecutive patients undergoing pancreatic resection for cancer was retrospectively analyzed to define factors that may affect the immediate postoperative outcome. Overall morbidity and mortality were 28.7% and 10.9%, respectively, although these figures were greatly reduced during the last years; the complication rate dropped from 55.6% (1981-1987) to 20.0% (1993-1995) and the mortality from 16.7% to 6.7%. At univariate statistical analysis the patient characteristics (sex, age, American Society of Anesthesiologists [ASA] class, nutritional status, jaundice), tumor characteristics (site, size, TNM stage, and grading), and type of surgery were found not to affect postoperative morbidity and mortality. In contrast, a significantly lower rate of complications was observed in patients not undergoing gastric resection, in those who received 3 units or less of blood intraoperatively, and in subjects operated more recently (after 1990). At multivariate analysis the period when the operation was performed was the only independent variable that affected the immediate postoperative outcome. Among the examined factors, only the experience acquired over time regarding the intra- and perioperative treatment of these patients seems able to lower the rate of postoperative complications.
对连续101例因癌症接受胰腺切除术的患者进行回顾性分析，以确定可能影响术后近期结局的因素。总体发病率和死亡率分别为28.7%和10.9%，尽管近年来这些数字大幅下降；并发症发生率从55.6%（1981 - 1987年）降至20.0%（1993 - 1995年），死亡率从16.7%降至6.7%。单因素统计分析发现，患者特征（性别、年龄、美国麻醉医师协会[ASA]分级、营养状况、黄疸）、肿瘤特征（部位、大小、TNM分期和分级）以及手术类型均不影响术后发病率和死亡率。相比之下，未接受胃切除术的患者、术中输血3单位及以下的患者以及近期（1990年后）接受手术的患者并发症发生率显著较低。多因素分析显示，手术时间是影响术后近期结局的唯一独立变量。在所检查的因素中，只有随着时间积累的关于这些患者围手术期治疗的经验似乎能够降低术后并发症发生率。
