胃癌根治术后并发症评价标准及风险预测

Evaluation criteria and risk prediction of postoperative complications after radical gastrectomy for gastric cancer

  • 摘要: 循证医学临床研究和大数据结果显示:胃癌胃切除术后吻合口漏、胰液漏、腹腔脓肿等为最常见的并发症,发生率约为20%,病死率约为1%。Clavien-Dindo分类标准、常见不良反应事件评价标准(CTCAE)4.0版和日本临床肿瘤学组(JCOG)的术后并发症标准,为胃癌外科临床研究中主要采用的并发症评价标准。功能状态评分、美国麻醉医师协会评分、生理学和手术严重程度评分系统、生理能力与手术侵袭度评分系统、急性生理学及慢性健康状况评分系统、Charlson共存病指数、虚弱性评价等主要用于评价手术风险程度和并发症预测。上述方法将各类风险指标量化后客观评价,有助于围术期管理和指导选择合理的手术方式。

     

    Abstract: The data of evidence-based medicine clinical trials and large databases showed that anastomotic leakage, pancreatic leakage and abdominal abscess were the most common complications after gastrectomy, and the complication rate was about 20% and mortality rate was about 1%. Postoperative complications criteria of gastric surgery is mainly used Clavien Dindo classification of surgical complications, Common Terminology Criteria for Adverse Events (CTCAE v4.0) and Japanese Clinical Oncology Group (JCOG) as evaluative standard. The performance status, American Society of Anesthesiologists score, physiological operative severity score for enumeration of mortality and morbidity (POSSUM), E-PASS scoring system, acute physiology and chroaic health evaluation (APACHEⅡ), Charlson comorbidity index and frailty score were used in predicting postoperative mortality and morbidity in gastric cancer patients. Authors can objectively evaluate risk of surgery and reasonably use these scoring systems for perioperative management.

     

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