Emergency surgeries for rectal cancer complicated by intestinal obstruction: long-term outcomes and prognostic factors
| Autor: | E. A. Kazantseva, E. V. Gordeeva, S. N. Shchaeva |
|---|---|
| Jazyk: | ruština |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis relapse-free survival Colorectal cancer business.industry Proportional hazards model medicine.medical_treatment Colostomy Neoplasms. Tumors. Oncology. Including cancer and carcinogens 030230 surgery Anastomosis medicine.disease Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine Emergency surgery 030220 oncology & carcinogenesis Relative risk medicine obstructive obstruction emergency surgery business rectal cancer RC254-282 |
| Zdroj: | Тазовая хирургия и онкология, Vol 10, Iss 1, Pp 11-19 (2020) |
| ISSN: | 2686-9594 |
| Popis: | The aim of the study: to examine the indicators of relapse-free survival and evaluate prognostic factors that had the greatest impact on relapse- free survival in patients with rectal cancer complicated by obstructive obstruction and undergoing emergency surgery.Materials and methods. The analysis of the immediate and long-term results of treatment – relapse-free survival of patients undergoing emergency surgery for rectal cancer complicated by obstructive obstruction in general surgical and specialized hospitals in Smolensk from 2001 to 2017 is presented. Relapse-free survival was analyzed by the Kaplan–Meier method. To determine the influence of potential risk factors on the rate of occurrence of the studied event, Cox regression was used.Results. Postoperative complications of the III–IV degree according to Clavien–Dindo were more common in patients undergoing emergency surgery for complicated rectal cancer in general surgical hospitals (p = 0.0056). In specialized hospitals, anastomosis leakage in 5.3 % (1 of 19 cases), in general surgical hospitals – 16.3 % (9 of 55 cases). Five-year relapse-free survival in general surgical hospitals at the IIB stage was 18.3 %, median survival – 32 months; in specialized hospitals at stage IIB 5‑year relapse-free was 45.8 %, median survival – 52 months (p = 0.028 and 0.011, respectively). A multivariate analysis confirmed the influence of the following factors on the performance of a 5‑year relapse-free survival: hospital specialization (risk ratio (RR) 1.35; 95 % confidence interval (CI) 1.18–1.55; p Conclusions. It is advisable to carry out two-stage surgical treatment with the formation of a colostomy at the first stage; the main stage of radical intervention should be performed in a specialized hospital. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|