Despite surgical improvements and pharmacological advances,management of late-stage gastric cancer patients,especially those with hepatic metastasis remains challenging[1–3].Although nationwide registry data from SEE...Despite surgical improvements and pharmacological advances,management of late-stage gastric cancer patients,especially those with hepatic metastasis remains challenging[1–3].Although nationwide registry data from SEER(Surveillance,Epidemiology,and End Results)[4]and the Nordic database[5]in Western countries have provided epidemiological information for patients with gastric cancer liver metastasis(GCLM),little is known about the detailed clinical characteristics.展开更多
Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study ...Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.展开更多
基金This work was supported by the National Natural Science Foundation of China(81972790)the Beijing Nova Program(Z181100006218011).
文摘Despite surgical improvements and pharmacological advances,management of late-stage gastric cancer patients,especially those with hepatic metastasis remains challenging[1–3].Although nationwide registry data from SEER(Surveillance,Epidemiology,and End Results)[4]and the Nordic database[5]in Western countries have provided epidemiological information for patients with gastric cancer liver metastasis(GCLM),little is known about the detailed clinical characteristics.
基金supported by National Nature Science Foundation of China(No.82172803).
文摘Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.
