Preoperative Risk Factors and Prognostic Impact of Postoperative Complications Associated with Total Gastrectomy
Preoperative Risk Factors and Prognostic Impact of Postoperative Complications Associated with Total Gastrectomy
复制标题
全胃切除术相关术后并发症的术前危险因素和预后影响
作者：
Nakazawa N;Sohda M;Yamaguchi A;Watanabe T;Saito H;Ubukata Y;Kuriyama K;Sano A;Sakai M;Ogawa H;Shirabe K;Saeki H.
我们评估了胃癌（GC）全胃切除术（TG）患者预测术后并发症的危险因素，包括吻合口漏、术后肺炎和心脏病。方法收集2009年5月至2017年5月在群马大学医学院接受TG治疗的GC患者106例，包括临床病理、手术、术后并发症、实验室检查和生理检查资料。结果106例患者中，无并发症92例（86.8%），有并发症14例（13.2%）。单因素分析显示，美国麻醉医师协会生理状态（ASA-PS）和中性粒细胞淋巴细胞比(NLR)≥3.5与术后并发症显著相关。多因素分析显示，高ASA-PS是术后并发症的独立预后因素。无并发症组肿瘤复发率为34.8%，并发症组为71.4%。结论术后并发症患者易复发，预后差。对于ASA-PS差、NLR高的高危GC患者，更彻底的围手术期管理至关重要。
IntroductionWe evaluated the risk factors for patients with gastric cancer (GC) undergoing total gastrectomy (TG) that predict postoperative complications, including anastomotic leakage, postoperative pneumonia, and heart disease.MethodsWe collected 106 patients who received TG for GC between May 2009 and May 2017 at Gunma University Graduate School of Medicine, including clinicopathologic, surgical, postoperative complication, laboratory test, and physiologic test data.ResultsOf 106 patients, 92 (86.8%) had no complications, and 14 (13.2%) had complications. Univariate analyses revealed that a high American Society of Anaesthesiologists physical status (ASA-PS) and neutrophil-lymphocyte ratio (NLR) of≥ 3.5 significantly correlated with postoperative complications. Multivariate analyses showed that high ASA-PS was an independent prognostic factor of postoperative complications. The cancer recurrence rate was 34.8% in the noncomplication group and 71.4% in the complication group.ConclusionPatients with postoperative complications are prone to recurrence and poor prognosis. For patients with high-risk GC with poor ASA-PS and high NLR, more thorough perioperative management is essential.