摘要
目的分析系统炎症反应指数(SII)对局部进展期胃癌新辅助治疗(nCRT)+腹腔镜胃癌根治术后并发症及预后的影响。方法回顾性分析2018年1月至2020年12月行nCRT+腹腔镜胃癌根治术的103例患者资料,根据术前SII的中位数分为高SII组(≥551.9,n=55例)和低SII组(<551.9,n=48例)。采用SPSS 21.0完成数据分析。并发症等计数资料比较采用χ^(2)检验,水肿和纤维化分级等比较采用秩和检验;围手术期指标等计量资料用(x±s)表示,行独立样本t检验;采用Kaplan-Meier生存函数分析不同SII组患者预后情况。P<0.05差异有统计学意义。结果高SII组患者手术时间、胃/食管-空肠Roux-Y吻合时间、术后住院时间显著长于低SII组(P<0.05);两组患者术中胃、胃周围淋巴结和周围肠管等组织水肿、纤维化分级比较,差异有统计学意义(P<0.05);两组患者术后并发症总发生率比较(16.4%vs.8.3%),差异无统计学意义(P>0.05),但高SII组并发症Clavien-Dindo分级Ⅲ级患者占比明显多于低SII组(P<0.05);高SII组患者累积总生存期(OS)和累积无病生存期(DFS)显著低于低SII组(Log-rankχ^(2)=4.790、3.986,P=0.032、0.044)。结论nCRT后腹腔镜胃癌根治术术前SII越高的患者,其胃、胃周围淋巴结和周围肠管等组织水肿和纤维化程度越严重,增加了手术和吻合难度,延长了手术时间,患者术后并发症分级更高,预后更差。
Objective To analyze the effects of systemic inflammatory response index(SII)on complications and prognosis after neoadjuvant therapy(nCRT)+laparoscopic radical gastrectomy for locally advanced gastric cancer.Methods The data of 103 patients who underwent nCRT+laparoscopic radical gastrectomy from January 2018 to December 2020 were retrospectively analyzed,and according to the median preoperative SII,they were divided into high SII group(≥551.9,n=55)and high SII group(<551.9,n=48).SPSS 21.0 was used to complete the data analysis.χ^(2)test was used to compare the count data of complications,rank sum test was used to compare the grade of edema and fibrosis.Measurement data such as perioperative indexes were expressed as(x±s),and independent sample t test was used.Kaplan-Meier survival function was used to analyze the prognosis of patients in different SII groups.P<0.05 was considered statistically significant.Results Operation time,gastric/esophago-jejunal Roux-Y anastomosis time and postoperative hospitalization time in high SII group were significantly longer than those in low SII group,and the differences were statistically significant(P<0.05).There were statistically significant differences in the grade of edema and fibrosis in stomach,perigastric lymph nodes and surrounding intestinal duct between the two groups(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(16.4%vs.8.3%)(P>0.05).However,the proportion of Clavien-Dindo gradeⅢpatients with complications in the high SII group was significantly higher than that in the low SII group,and the difference was statistically significant(P<0.05).The cumulative OS and DFS in the high SII group were significantly lower than those in the low SII group(Log-rankχ^(2)=4.790,3.986,P=0.032,0.044).Conclusion After neoadjuvant therapy,patients with higher SII before laparoscopic radical gastrectomy for gastric cancer had more severe edema and fibrosis in the stomach,perigastric lymph nodes and surroun
作者
王东阳
林琳
娄熙彬
Wang Dongyang;Lin Lin;Lou Xibin(The 900th Hospital General Surgery,Fuzhou 350001,China)
出处
《中华普外科手术学杂志（电子版）》
2024年第3期315-318,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胃肿瘤
胃切除术
腹腔镜
系统炎症反应指数
新辅助治疗
并发症
预后
Neoplasm of Stomach
Gastrectomy
Laparoscopy
Systemic Inflammatory Response Index
Neoadjuvant Therapy
Complication
Prognosis
