医学
胃切除术
析因分析
随机对照试验
癌症
外科
普通外科
内科学
作者
Yusuke Taki,Seiji Ito,Junki Mizusawa,Masahiro Yura,Yuya Sato,Takashi Nomura,Masahiro Tsuda,Takeshi Omori,Chikara Kunisaki,Yasuhiro Choda,Haruhiko Cho,Naoki Hiki,Narikazu Boku,Takaki Yoshikawa,Hitoshi Katai,Masanori Terashima
出处
期刊:Ejso
[Elsevier]
日期:2024-01-01
卷期号:: 107982-107982
标识
DOI:10.1016/j.ejso.2024.107982
摘要
Background Abdominal surgical infectious complications (ASIC) after gastrectomy for gastric cancer impair patients' survival and quality of life. JCOG0912 was conducted to compare laparoscopy-assisted distal gastrectomy with open distal gastrectomy for clinical stage IA or IB gastric cancer. The present study aimed to identify risk factors for ASIC using prospectively collected data. Methods We performed a post-hoc analysis of the risk factors for ASIC using the dataset from JCOG0912. All complications were evaluated according to the Clavien–Dindo classification (CD). ASIC was defined as CD grade I or higher anastomotic leakage, pancreatic fistula, abdominal abscess, and wound infection. Analyses were performed using the logistic regression model for univariable and multivari able analyses. Results A total of 910 patients were included (median age, 63 years; male sex, 61 %). Among them, ASIC occurred in 5.8 % of patients. In the univariable analysis, male sex (odds ratio [OR] 2.855, P = 0.003), diabetes (OR 2.565, P = 0.029), and Roux-en-Y (R–Y) reconstruction (vs. Billroth Ⅰ, OR 2.707, P = 0.002) were significant risk factors for ASIC. In the multivariable analysis, male sex (OR 2.364, P = 0.028) and R–Y reconstruction (vs. Billroth Ⅰ, OR 2.310, P = 0.015) were independent risk factors for ASIC. Conclusions Male sex and R–Y reconstruction were risk factors for ASIC after distal gastrectomy. Therefore, when performing surgery on male patients or when R–Y reconstruction is selected after gastrectomy for gastric cancer, surgeons should pay special attention to prevent ASIC.
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