胃癌全胃切除术后并发症的危险因素分析:脾切除术与保脾手术的比较——JCOG0110的补充分析

IF 1.8 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Digestive Surgery Pub Date : 2023-01-01 DOI:10.1159/000531192
Seiji Ito, Takeshi Sano, Junki Mizusawa, Masanori Tokunaga, Tadayoshi Hashimoto, Hiroshi Imamura, Shin Teshima, Koei Nihei, Makoto Yamada, Yasuhiro Choda, Kazuhiro Imamura, Shinji Hato, Masanori Terashima, Mitsuru Sasako
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引用次数: 0

摘要

简介:在一项澄清脾切除术作用的随机试验(JCOG0110研究)中,发现脾切除术对近端胃癌没有生存益处。虽然许多研究探讨了全胃切除术后发病的危险因素,但没有研究评估保脾全胃切除术术后并发症的危险因素。方法:使用先前随机试验的505例患者的数据,通过多变量logistic回归分析确定术后并发症的危险因素。然后分别评估脾切除术和保脾全胃切除术的危险因素。结果:术后并发症119例(23.6%),脾切除术比保脾手术更常见(30.7%和16.1%);0.01)。多变量分析显示,年龄≥65岁(p = 0.032)、体重指数≥25 (p = 0.003)、出血量≥350 (p = 0.019)是整个队列术后并发症的独立危险因素。其中,只有体重指数是保脾组(p = 0.047)和脾切除术组(p = 0.017)并发症的显著独立危险因素。结论:脾切除与保脾术后并发症的危险因素基本相同。超重增加了术后并发症的风险。
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Identifying Risk Factors of Complications following Total Gastrectomy for Gastric Cancer: Comparison between Splenectomy and Spleen-Preserving Surgery - A Supplementary Analysis of JCOG0110.

Introduction: Splenectomy for proximal gastric cancer was found to offer no survival benefit in a randomized trial clarifying the role of splenectomy (JCOG0110 study). Although many studies have explored risk factors for morbidities following total gastrectomy, none have assessed the risk factors for postoperative complications in spleen-preserving total gastrectomy.

Methods: Using data from 505 patients enrolled in a previous randomized trial, risk factors for postoperative complications were identified by multivariable logistic regression analysis. Then, the risk factors were assessed separately between splenectomy and spleen-preserving total gastrectomy.

Results: Postoperative complications were identified in 119 patients (23.6%) and were more common following splenectomy than following spleen-preserving surgery (30.7% and 16.1%, respectively, p < 0.01). Multivariable analysis revealed that age ≥65 years (p = 0.032), body mass index ≥25 (p = 0.003), and blood loss ≥350 (p = 0.019) were independent risk factors for postoperative complications in the entire cohort. Among them, only body mass index was a significant independent risk factor for complications in both spleen preservation (p = 0.047) and splenectomy groups (p = 0.017).

Conclusion: Risk factors for postoperative complications were essentially the same between splenectomy and spleen preservation. Being overweight increased the risk of postoperative complications.

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来源期刊
Digestive Surgery
Digestive Surgery 医学-外科
CiteScore
4.90
自引率
3.70%
发文量
25
审稿时长
3 months
期刊介绍: ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.
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