論文

査読有り
2020年6月

Emergency surgery for gastrointestinal cancer: A nationwide study in Japan based on the National Clinical Database

ANNALS OF GASTROENTEROLOGICAL SURGERY
  • Nobuaki Hoshino
  • ,
  • Hideki Endo
  • ,
  • Koya Hida
  • ,
  • Nao Ichihara
  • ,
  • Yoshimitsu Takahashi
  • ,
  • Hiroshi Hasegawa
  • ,
  • Toshimoto Kimura
  • ,
  • Yuko Kitagawa
  • ,
  • Yoshihiro Kakeji
  • ,
  • Hiroaki Miyata
  • ,
  • Takeo Nakayama
  • ,
  • Yoshiharu Sakai

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/ags3.12353
出版者・発行元
WILEY-V C H VERLAG GMBH

Background Emergency gastrointestinal surgery, although rare, is known for its high mortality and morbidity. However, the risks of emergency surgery for gastrointestinal cancer have not been investigated in depth. This study aimed to investigate the impact of emergency surgery on mortality and morbidity in patients with gastrointestinal cancers and to identify associated risk factors. Methods We extracted data from the National Clinical Database, a nationwide surgery registration system in Japan, for patients with gastrointestinal cancer who underwent esophageal resection, total gastrectomy, distal gastrectomy, right hemicolectomy, or low anterior resection between 2012 and 2017. The impacts of emergency surgery on 30-day mortality and incidence of overall postoperative complications were compared with those of non-emergency surgery. Risk factors for mortality and overall postoperative complications were then sought in patients who underwent emergency surgery. Results Thirty-day mortality and incidence of overall postoperative complications were significantly higher in emergency surgeries for gastric, colon, and rectal cancers than in non-emergency surgeries (odds ratios 4.86-6.98 and 1.68-2.18, respectively; allP < .001). Various risk factors were identified in the group that underwent emergency surgery, including preoperative sepsis and lower body mass index. Some of the risk factors were common to all types of surgery and others were specific to a certain type of surgery. Conclusion The actual risk of emergency surgery and the risk factors for overall postoperative complications in emergency cases are shown to serve as a reference for postoperative management. Emergency surgery had an additional burden on patients depending on the type of surgery.


リンク情報
DOI
https://doi.org/10.1002/ags3.12353
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000543536500001&DestApp=WOS_CPL

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