Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer
Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer
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DOI：
10.1159/000443219
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发表时间：
2016-01-01
影响因子：
2.7
通讯作者：
Kodera, Yasuhiro
中科院分区：
文献类型：
--
作者：
Mizuno, Akira;Kanda, Mitsuro;Kodera, Yasuhiro
背景/目的：胃切除术合并全身淋巴结切除术有时会引起大量出血，即使是经验丰富的外科医生。本研究的目的是评估术中估计失血量（EBL）如何影响II/III期胃癌（GC）患者手术后的长期预后。方法：本研究纳入1999 - 2015年间未接受围手术期输血的II/III期GC患者203例。回顾性确定EBL的最佳临界值及预后意义。结果：EBL中位数为285 ml。受试者工作特征曲线分析确定400 ml为最佳临界值。多变量分析表明EBL = 400 ml的患者比EBL = 400 ml的患者更容易发生肝脏复发，预后更差。根据辅助化疗给药情况对患者进行细分时，EBL >= 400与
Background/Aims: Gastrectomy with systemic lymphadenectomy sometimes causes excessive bleeding even by experienced surgeons. The aim of this study was to evaluate how intraoperative estimated blood loss (EBL) affected the long-term outcomes after curative surgery of patients with stage II/III gastric cancer (GC). Methods: This study included 203 patients with stage II/III GC who did not receive perioperative blood transfusion between 1999 and 2015. The optimal cutoff and the prognostic significance of EBL were determined retrospectively. Results: The median EBL was 285 ml. Receiver operating characteristic curve analysis identified 400 ml as an optimal cutoff. Patients with EBL >= 400 ml were more likely to have hepatic relapse and worse prognosis compared to those with EBL = 400 ml was identified as an independent prognostic factor for mortality by multivariable analysis. When patients were subdivided according to administration of adjuvant chemotherapy, there was a significant difference between the EBL >= 400 and