JAMA Surg:术前膳食纤维摄入与结直肠癌患者术后并发症风险研究

2021-06-23 MedSci原创 MedSci原创

手术前习惯性摄入较高膳食纤维人群,结直肠癌术后并发症风险较低

在西方国家,手术是治疗早期结肠直肠癌(CRC)的重要方法,在肿瘤切除后,15%至50%的患者会出现严重并发症,如吻合口渗漏、感染或梗阻,严重影响患者生活质量,延长住院时间,导致再入院和死亡风险增加。作为与肠道健康的一个重要可调节因素,膳食纤维摄入量与结直肠癌风险相关,近日研究人员考察了术前膳食纤维摄入与术后并发症风险之间的关系。

COLON研究考察了营养和生活方式因素对结直肠疾病的影响,来自荷兰11个医疗中心的成年结直肠癌患者参与,不限制患者疾病阶段,患者接受了择期手术,通过204项食物摄入频率问卷评估习惯性膳食纤维摄入量。研究的主要终点为术后30天内发生的任何并发症、手术并发症和吻合口瘘。

总计1399名患者参与研究,平均年龄为66岁,896名(64%)为男性。397例(28%)患者出现任何原因并发症, 235例(17%)发生外科手术引起的并发症,67例(5%)发生吻合口瘘。较高的膳食纤维摄入量与较低的并发症风险(每日每增加10g膳食纤维摄入比值比[OR]:0.75)和较低的手术并发症风险相关(OR:0.76),但与吻合口瘘风险不相关(OR:0.97)。在女性中,较高的膳食摄入与任何并发症风险降低相关(OR:0.64),但男性患者中的相关性较弱(OR:0.79)。从蔬菜中摄入纤维与任何并发症(每日每增加1个膳食纤维摄入OR:0.90)和手术并发症(OR:0.87)风险呈负相关。

膳食纤维来源于并发症风险

研究发现,手术前习惯性摄入较高膳食纤维人群,结直肠癌术后并发症风险较低

原始出处:

Dieuwertje E. Kok et al. Association of Habitual Preoperative Dietary Fiber Intake With Complications After Colorectal Cancer Surgery. JAMA Surg. June 16,2021.

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    2021-12-19 丁鹏鹏
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    2021-06-25 zhaojie88
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2055729, encodeId=2fb82055e2947, content=<a href='/topic/show?id=734110089320' target=_blank style='color:#2F92EE;'>#风险研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100893, encryptionId=734110089320, topicName=风险研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Apr 15 21:59:20 CST 2022, time=2022-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758334, encodeId=24b51e58334ed, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sun Dec 19 08:59:20 CST 2021, time=2021-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350445, encodeId=ceda1350445d0, content=<a href='/topic/show?id=224a85904ad' target=_blank style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453532, encodeId=3b7a1453532cc, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466273, encodeId=713914662e320, content=<a href='/topic/show?id=afda85920c3' target=_blank style='color:#2F92EE;'>#膳食纤维摄入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85920, encryptionId=afda85920c3, topicName=膳食纤维摄入)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dea96793953, createdName=linne322, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036696, encodeId=c0a51036696c6, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 23 23:59:20 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976335, encodeId=58f49e633530, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d075532684, createdName=川贝, createdTime=Wed Jun 23 21:38:04 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976333, encodeId=5ca99e633389, content=术前饮食的重要性, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49db5104520, createdName=爱灵魂, createdTime=Wed Jun 23 21:35:28 CST 2021, time=2021-06-23, status=1, ipAttribution=)]
    2021-06-23 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2055729, encodeId=2fb82055e2947, content=<a href='/topic/show?id=734110089320' target=_blank style='color:#2F92EE;'>#风险研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100893, encryptionId=734110089320, topicName=风险研究)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Apr 15 21:59:20 CST 2022, time=2022-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758334, encodeId=24b51e58334ed, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Sun Dec 19 08:59:20 CST 2021, time=2021-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350445, encodeId=ceda1350445d0, content=<a href='/topic/show?id=224a85904ad' target=_blank style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453532, encodeId=3b7a1453532cc, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466273, encodeId=713914662e320, content=<a href='/topic/show?id=afda85920c3' target=_blank style='color:#2F92EE;'>#膳食纤维摄入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85920, encryptionId=afda85920c3, topicName=膳食纤维摄入)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dea96793953, createdName=linne322, createdTime=Fri Jun 25 11:59:20 CST 2021, time=2021-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036696, encodeId=c0a51036696c6, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 23 23:59:20 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976335, encodeId=58f49e633530, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9d075532684, createdName=川贝, createdTime=Wed Jun 23 21:38:04 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=976333, encodeId=5ca99e633389, content=术前饮食的重要性, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49db5104520, createdName=爱灵魂, createdTime=Wed Jun 23 21:35:28 CST 2021, time=2021-06-23, status=1, ipAttribution=)]
    2021-06-23 川贝

    学习了

    0

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    2021-06-23 爱灵魂

    术前饮食的重要性

    0

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Nature Medicine:结直肠癌患者要不要接种COVID-19疫苗

癌症患者避免在试验性治疗后48-72小时内接种疫苗,但COVID-19疫苗接种的利益-风险状况仍然强烈支持在这一人群中接种疫苗。在疫苗推出期间优先考虑癌症患者是至关重要的。

JAMA Netw Open:结直肠癌发病率骤升,35岁就要开始预防?!

在全世界范围内,结直肠癌(CRC)是第三大常见癌症。据最新全球癌症统计分析显示,2020年,美国新诊断为结直肠癌的患者为14.8万人,死亡5.3万人。

Radiology:mt-sDNA和CT结肠造影在结直肠癌筛查中的应用

光学结肠镜检查仍然是结直肠癌(CRC)筛查的主要手段,并且有助于CRC的预防和早期诊断。

ASCO 2021: 摘要概览与展望 16 |ctDNA在预测结直肠癌复发及全程管理中的潜在作用

2021年ASCO上,公布了用ctDNA检测评估结直肠癌患者的复发风险的结果。

Lancet oncol:未知因素明显影响林奇综合征患者罹患结直肠癌的风险

林奇综合征患者之间发生结直肠癌的风险仍存在很大差异,不能以一言概之