DCR:体弱患者接受机器人手术治疗结肠癌会导致更严重的术后并发症的发生

2020-04-19 MedSci原创 MedSci原创

目前微创手术越来越受到医生和患者的青睐,但是,人们对机器人手术对某些特定人群的影响(如体弱的患者)了解甚少。本项研究的目的是探究体弱患者与微创手术方法与结肠癌手术之间的关联。

背景及目的:目前微创手术越来越受到医生和患者的青睐,但是,人们对机器人手术对某些特定人群的影响(如体弱的患者)了解甚少。本项研究的目的是探究体弱患者与微创手术方法与结肠癌手术之间的关联。

方法:这是一项回顾性研究。使用多变量logistic回归与倾向评分权重比较30天的手术结果,并测试体质强弱和手术方法之间的相互影响。研究人员从美国外科医生学院国家外科手术质量改善计划数据库中挑选出2012年至2016年接受开放,腹腔镜或机器人结肠切除术治疗原发性结肠癌的患者。测量的主要结果是术后30天的并发症。

结果:在对结肠切除术患者进行倾向得分加权后,进行腹腔镜手术的占33.8%(n = 27649),而进行腹腔镜手术的占34.3%(n=28058),而进行机器人手术的占31.9%(n=26,096)。机器人手术(OR,0.53;95%CI,0.42-0.69,p <0.001)和腹腔镜手术(OR,0.58; 95%CI,0.52-0.66,p <0.001)与重大并发症发生率的降低独立相关。体弱的患者并发症发生率增加(OR,1.56; 95%CI,1.07–2.25,p = 0.018)。在考虑手术方法与虚弱之间的相互作用时,与接受开放手术的患者相比,接受机器人手术的体弱患者更有可能发生重大并发症(OR,3.15; 95%CI,1.34-7.45,p = 0.009)。

结论:尽管微创外科手术减少了术后并发症,但在体弱的患者中这种作用可能会适得其反。

原始出处:

Lo, Brian D. B.S. et al. Frailer Patients Undergoing Robotic Colectomies for Colon Cancer Experience Increased Complication Rates Compared With Open or Laparoscopic Approaches. Diseases of the Colon & Rectum.2020.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1758236, encodeId=da6c1e5823671, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Tue Jun 30 11:33:58 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290744, encodeId=703f1290e44d6, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322102, encodeId=c3131322102c3, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554726, encodeId=d8b11554e2650, content=<a href='/topic/show?id=e8bd61194f8' target=_blank style='color:#2F92EE;'>#机器人手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61194, encryptionId=e8bd61194f8, topicName=机器人手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc6314549514, createdName=echonoir, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583235, encodeId=1d811583235f3, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=)]
    2020-06-30 丁鹏鹏
  2. [GetPortalCommentsPageByObjectIdResponse(id=1758236, encodeId=da6c1e5823671, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Tue Jun 30 11:33:58 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290744, encodeId=703f1290e44d6, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322102, encodeId=c3131322102c3, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554726, encodeId=d8b11554e2650, content=<a href='/topic/show?id=e8bd61194f8' target=_blank style='color:#2F92EE;'>#机器人手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61194, encryptionId=e8bd61194f8, topicName=机器人手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc6314549514, createdName=echonoir, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583235, encodeId=1d811583235f3, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1758236, encodeId=da6c1e5823671, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Tue Jun 30 11:33:58 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290744, encodeId=703f1290e44d6, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322102, encodeId=c3131322102c3, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554726, encodeId=d8b11554e2650, content=<a href='/topic/show?id=e8bd61194f8' target=_blank style='color:#2F92EE;'>#机器人手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61194, encryptionId=e8bd61194f8, topicName=机器人手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc6314549514, createdName=echonoir, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583235, encodeId=1d811583235f3, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=)]
    2020-04-21 xue8602
  4. [GetPortalCommentsPageByObjectIdResponse(id=1758236, encodeId=da6c1e5823671, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Tue Jun 30 11:33:58 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290744, encodeId=703f1290e44d6, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322102, encodeId=c3131322102c3, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554726, encodeId=d8b11554e2650, content=<a href='/topic/show?id=e8bd61194f8' target=_blank style='color:#2F92EE;'>#机器人手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61194, encryptionId=e8bd61194f8, topicName=机器人手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc6314549514, createdName=echonoir, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583235, encodeId=1d811583235f3, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1758236, encodeId=da6c1e5823671, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, 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=Tue Jun 30 11:33:58 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290744, encodeId=703f1290e44d6, content=<a href='/topic/show?id=e86454454ea' target=_blank style='color:#2F92EE;'>#手术治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54454, encryptionId=e86454454ea, topicName=手术治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=920c231, createdName=lixiaol, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322102, encodeId=c3131322102c3, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554726, encodeId=d8b11554e2650, content=<a href='/topic/show?id=e8bd61194f8' target=_blank style='color:#2F92EE;'>#机器人手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61194, encryptionId=e8bd61194f8, topicName=机器人手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc6314549514, createdName=echonoir, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583235, encodeId=1d811583235f3, content=<a href='/topic/show?id=f6e1611840d' target=_blank style='color:#2F92EE;'>#机器#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61184, encryptionId=f6e1611840d, topicName=机器)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=13dc16973127, createdName=ms6279672939590805, createdTime=Tue Apr 21 07:33:58 CST 2020, time=2020-04-21, status=1, ipAttribution=)]

相关资讯

JAMA:手术入路与全髋关节置换患者术后并发症风险

前入路受全髋关节置换可减少患者术后并发症风险

JACC:近一半的心脏病孕妇并发症是可预防的

妊娠可能导致心脏病妇女的并发症,这些并发症可能危及生命。了解严重的并发症以及如何预防是很重要的。本研究的主要目的是评估心脏病孕妇的严重心脏病事件(SCEs)的发生率,以及其是否可预防和对新生儿预后的影

BMJ: 不同围术期干预措施对预防术后肺部并发症

本项研究旨在评估有关不同围手术期的干预在减少成年非心脏手术成年患者术后肺部并发症(PPC)疗效的差异。

JAMA Cardiol:老年晚期心衰患者中与植入式心脏复律除颤器相关的围手术期风险和生存率

在接受ICD或CRT-D植入以预防心源性猝死的患者中,只有一小部分患者为晚期HF。与非晚期HF患者相比,这些患者与院内死亡和心脏骤停相关的临床重要围手术期并发症的发生率较高。

Clin Otolaryngol:与嗜酸性慢性鼻窦炎相关的并发症分析

嗜酸性慢性鼻窦炎(ECRS)是CRS的一种组织学亚型,并且治疗难度更大。与非ECRS患者相比,患有ECRS的患者症状更重,且鼻窦手术后治疗效果差。手术前ECRS的组织病理学和生物标志物评估通常是不可用

Eur Arch Otorhinolaryngol:耳蜗移植的手术并发症分析

尽管耳蜗移植技术已经很先进,但是相关的并发症发生率还是很高。最近,有研究人员使用紧密随访的一个大的患者群体数据进行了案例分析,鉴定了与耳蜗移植相关的并发症,并展现了他们使用的手术经验和技术,以遵循手术