Outcomes and Prognostic Factors in Patients who Underwent Palliative Surgery for Malignant Bowel Obstruction due to Peritoneal Dissemination
- 1 January 2020
- journal article
- Published by Japan Surgical Association in Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
- Vol. 81 (6), 1029-1035
- https://doi.org/10.3919/jjsa.81.1029
Abstract
目的:腹膜播種による悪性腸閉塞に対する緩和手術成績を検討し,予後因子を求める. 方法:2006-2017年に当科で緩和手術を施行した58例を対象として,後方視学的に検討を加えた.各症例においてGlasgow Prognostic Score(GPS),Prognostic Nutrition Index,Neutrophil/ Lymphocyte Ratioを算出し,他の臨床因子とともに予後との関連を検討した. 結果:短期成績は,食事再開率:84.5%,退院達成率:89.7%,術後合併症率:31.0%であった.Median Survival Time:5.1カ月で,術後に8週以上の化学療法を施行した症例は,化学療法非施行例と比較して有意に予後良好であった.多変量解析では,性別,PS,腹水量,腸管閉塞部位数,GPSが予後因子として抽出された. 結論:当科の緩和手術成績は過去の報告と比較して遜色のないものであった.PS:3以上,腹水が中等量以上,閉塞部位が2箇所以上,GPS:2の症例は予後不良であることが多く,緩和手術の適応は慎重に判断するべきである.This publication has 8 references indexed in Scilit:
- Acute malignant obstruction in patients with peritoneal carcinomatosis: The role of palliative surgeryEuropean Journal of Surgical Oncology, 2019
- Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical managementBMC Cancer, 2018
- Factors related to difficult self‐expandable metallic stent placement for malignant colonic obstruction: A post‐hoc analysis of a multicenter study across JapanDigestive Endoscopy, 2018
- Surgical management of bowel obstruction in patients with peritoneal carcinomatosisJournal of Surgical Oncology, 2014
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Performance Status of Male and Female Advanced Cancer Patients Is Independently Predicted by Mid-Upper Arm Circumference MeasurementNutrition and Cancer, 2002
- Outcome of Palliative Operations for Malignant Bowel Obstruction in Patients With Peritoneal Carcinomatosis From Nongynecological CancerAnnals of Surgical Oncology, 2001
- Survival and quality of life after palliative surgery for neoplastic gastrointestinal obstructionEuropean Journal of Surgical Oncology, 2001