Postoperative infectious complications have a negative oncological impact in patients after stent placement with malignant large bowel obstruction

被引：4

作者：

Matsuda, Akihisa ^{[1
]}

Yamada, Takeshi ^{[1
]}

Takahashi, Goro ^{[1
]}

Matsumoto, Satoshi ^{[2
]}

Yokoyama, Yasuyuki ^{[3
]}

Sonoda, Hiromichi ^{[1
]}

Ohta, Ryo ^{[3
]}

Shinji, Seiichi ^{[1
]}

Sekiguchi, Kumiko ^{[4
]}

Kuriyama, Sho ^{[1
]}

Kanaka, Shintaro ^{[1
]}

Yoshida, Hiroshi ^{[1
]}

机构：

[1] Nippon Med Sch, Dept Gastrointestinal & Hepatobiliary Pancreat Sur, 1-1-5 Sendagi,Bunkyo Ku, Tokyo 1138603, Japan

[2] Nippon Med Sch, Dept Surg, Chiba Hokusoh Hosp, 1715 Kamagari, Chiba 2701694, Japan

[3] Nippon Med Sch, Dept Digest Surg, Musashi Kosugi Hosp, 1-396 Kosugi Cho,Nakahara Ku, Kawasaki, Kanagawa 2118533, Japan

[4] Nippon Med Sch, Dept Surg, Tama Nagayama Hosp, Tokyo, Tama 2068512, Japan

来源：

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE | 2023年 / 38卷 / 01期

关键词：

Bridge to surgery; Colonic stent; Postoperative infection; Survival; SURGICAL SITE INFECTION; COLORECTAL-CANCER; EMERGENCY-SURGERY; COLONIC OBSTRUCTION; ANASTOMOTIC-LEAK; PROSPECTIVE MULTICENTER; METALLIC STENTS; BRIDGE; EFFICACY; SAFETY;

D O I：

10.1007/s00384-022-04290-9

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Purpose In this study, we aimed to investigate the oncological impact of postoperative infection in patients with malignant large bowel obstruction managed by self-expandable metallic stent placement as a bridge to surgery. Methods The cohort of this multicenter retrospective study comprised 129 patients with pathological stage II/III malignant large bowel obstruction who had undergone bridge to surgery. Patients were allocated to no-postoperative infection (n = 116) and postoperative infection groups (n = 13). Results The postoperative infection group had a significantly greater proportion of men, fewer harvested lymph nodes, and longer postoperative hospital stays than did the no-postoperative infection group. Self-expandable metallic stent-related variables, including clinical failure, were not associated with postoperative infection. Male sex and low body mass index were identified as risk factors for postoperative infection by multivariate logistic regression. Three-year relapse-free survival rates were 75.5% and 30.8% in the no-postoperative infection and postoperative infection groups, respectively; this difference is statistically significant. Male sex, postoperative infection, and T4 were identified as independent prognostic factors by multivariate Cox proportional hazard analysis. The postoperative infection group had a significantly higher total recurrence rate and shorter interval to recurrence than did the no-postoperative infection group. Conclusion To the best of our knowledge, this is the first study to show that postoperative infection in bridge to surgery patients has a negative oncological impact. This finding indicates that further improvement in perioperative management of bridge to surgery patients is required to minimize postoperative infection and that patient-risk stratification and additional therapy would contribute to improving oncological outcomes.

引用

页数：12

共 52 条

[51] Self-expanding metallic stent as a bridge to surgery versus emergency surgery for obstructive colorectal cancer: a meta-analysis [J].

Zhang, Yi ;

Shi, Jian ;

Shi, Bin ;

Song, Chun-Yan ;

Xie, Wei-Fen ;

Chen, Yue-Xiang .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2012, 26 (01) :110-119

[52] Bundles Prevent Surgical Site Infections After Colorectal Surgery: Meta-analysis and Systematic Review [J].

Zywot, Aleksander ;

Lau, Christine S. M. ;

Fletcher, H. Stephen ;

Paul, Subroto .

JOURNAL OF GASTROINTESTINAL SURGERY, 2017, 21 (11) :1915-1930

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