腹腔镜胃癌根治术后吞咽困难的危险因素分析。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Sang-Sang Chen, Zhe-Bin Dong, Han-Ting Xiang, Zheng-Wei Chen, Tian-Ci Chen, Jia-Rong Huang, Chao Liang, Wei-Ming Yu
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引用次数: 0

摘要

背景:胃癌是世界上最常见的恶性肿瘤之一。尽管放化疗、靶向治疗和新辅助治疗取得了重大进展,但传统的手术干预仍然是胃癌治疗的基石。手术技术的改进,加上吻合器和其他先进器械的使用,大大降低了胃癌手术后并发症的发生率和死亡率。然而,吞咽困难仍然是常见的术后并发症。目的:回顾性分析腹腔镜胃癌根治术患者发生吞咽困难的潜在因素,探讨其术后有效处理策略。方法:在这项回顾性研究中,我们分析了2018年1月至2022年5月在宁波大学丽慧丽医院行选择性腹腔镜全胃切除术的患者的数据。共纳入115例符合条件的术后患者。术后,患者完成问卷调查,并根据其回答分为两组:吞咽困难组(进食评估工具-10评分≥3)和非吞咽困难组(进食评估工具-10评分< 3)。采用χ 2检验、Fisher精确检验、t检验、Pearson相关系数、单因素和多因素回归分析评估全胃切除术后与吞咽困难相关的危险因素。结果:多因素分析进一步确定吻合方式、插管时间延长、高龄和低白蛋白水平是术后吞咽困难的独立危险因素。对高危人群实施针对性的预防措施可显著提高术后生活质量。结论:单因素分析显示吻合方式、低血清ALB水平、高龄、插管时间延长与胃癌患者术后吞咽困难有显著相关性。多因素分析进一步发现吻合方式、插管时间延长、高龄和低ALB水平是术后吞咽困难的独立危险因素。对高危人群实施针对性的预防措施可显著提高术后生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of risk factors for dysphagia in patients after laparoscopic radical gastrectomy.

Background: Gastric cancer is among the most prevalent malignancies worldwide. Despite significant advancements in chemoradiotherapy, targeted therapy, and neoadjuvant therapy, conventional surgical intervention remains the cornerstone of gastric cancer management. Improvements in surgical techniques, coupled with the use of staplers and other advanced instruments, have substantially reduced the incidence of complications and mortality following gastric cancer surgery. However, dysphagia remains a common postoperative complication.

Aim: To retrospectively investigate the potential factors contributing to dysphagia in patients who have undergone laparoscopic radical gastrectomy for gastric cancer and to explore effective strategies for its postoperative management.

Methods: In this retrospective study, we analyzed data from patients who underwent elective laparoscopic total gastrectomy at Lihuili Hospital, Ningbo University, between January 2018 and May 2022. A total of 115 eligible postoperative patients were included. Postoperatively, patients completed questionnaires and were categorized into two groups based on their responses: The dysphagia group (Eating Assessment Tool-10 score ≥ 3) and the non-dysphagia group (Eating Assessment Tool-10 score < 3). Risk factors associated with dysphagia following total gastrectomy were assessed using χ 2 tests, Fisher's exact tests, t-tests, Pearson correlation coefficients, and univariate and multivariate regression analyses.

Results: Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low albumin (ALB) levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.

Conclusion: Univariate analysis revealed that anastomotic style, low serum ALB levels, advanced age, and prolonged intubation time were significantly associated with postoperative dysphagia in gastric cancer patients. Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low ALB levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.

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