摘要
吻合口瘘是食管癌术后最严重的并发症之一。预测因子的研究对其预防至关重要。血液指标如C反应蛋白、白细胞水平、降钙素原和白蛋白水平因获取容易被广泛应用,但难以区分吻合口漏与其他术后感染。吻合口血供情况,如血管长度和直径,易获取且在预测模型中价值高,但相关研究较少。吲哚菁绿使用能更直观评估血供情况,但应用不广泛,数据获取困难。糖尿病等术前合并症已被证明会延迟伤口愈合,增加风险,建议联合其他因素进行综合研究。手术方式和吻合部位等内容已被详细研究,但仍需探讨更多细节。研究人员应综合以上因素,构建多因素预测模型,以便在术前识别高风险病人,采取有效预防措施,减少吻合口瘘的发生。
Anastomotic leakage is one of the most severe complications following esophagectomy.Research on predictive factors is crucial for its prevention.Blood markers such as C-reactive protein,white blood cell count,procalcitonin,and albumin levels are widely used due to their accessibility,but they have limitations in distinguishing anastomotic leakage from other postoperative infections.The assessment of blood supply to the anastomotic site,including factors like vessel length and diameter,is also readily obtainable and valuable in predictive models,though there is limited research in this area.The use of indocyanine green offers a more direct evaluation of blood supply,but its application is not widespread,and data acquisition is challenging.Preoperative comorbidities such as diabetes have been shown to delay wound healing and increase the risk of leakage;thus,it is recommended to include these factors in comprehensive studies.Although surgical techniques and the location of the anastomosis have been extensively studied,further exploration of these details is necessary.Researchers should integrate these factors to develop multifactorial predictive models,enabling the identification of high-risk patients preoperatively and the implementation of effective preventive measures to reduce the incidence of anastomotic leakage.
作者
陈海南
冷雪峰
CHEN Hainan;LENG Xuefeng(Department of Thoracic Surgery,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,Affiliated Cancer Hospital of University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)
出处
《临床外科杂志》
2024年第8期892-895,共4页
Journal of Clinical Surgery
基金
国家自然科学基金面上项目(82472663)
四川省国际科技创新合作项目(2024YFHZ0322)
四川省科技计划项目(2023YFS0044)
成都市重点研发项目(2024-YF05-00797-SN)
吴阶平医学基金会临床科研专项资助基金(320.6750.2023-05-141)
四川省临床重点专科建设项目([2022]70)。
关键词
食管癌术后
吻合口瘘
预测模型
after surgery for esophageal cancer
anastomotic leakage
predictive model
