新辅助化疗后机器人胃癌根治术后并发症的影响因素分析

目的:探讨新辅助化疗后机器人胃癌根治术后近期并发症的相关危险因素,以期为有效预防术后并发症拓展思路.方法:回顾收集2012年11月至2020年10月行新辅助化疗后机器人胃癌根治术的89例胃癌患者的临床资料与病理资料.并发症分级按照Clavien-Dindo系统进行评价.采用二元logistic回归分析影响新辅助化疗后机...

Risk factors of complications after robotic radical gastrectomy for gastric cancer after neoadjuvant chemotherapy

Objective:To explore the risk factors related to the postoperative short-term complications after robotic gastrectomy for gastric cancer after neoadjuvant chemotherapy,and to expand ideas for the effective prevention of postoperative complications.Methods:Retrospective study was carried out.The clinical and pathological data of 89 gastric cancer patients who underwent robotic gastrectomy after neoadjuvant chemotherapy between Nov.2012 and Oct.2020 were retrospectively collected.Complications were graded according to the Clavien-Dindo system.The risk factors of postoperative complications of robotic radical gastrectomy after neoadjuvant chemotherapy were analyzed by binary logistic analysis,and the factors with P<0.2 in univariate analysis were included in multivariate logistic analysis.The overall survival and disease-free survival were analyzed by Kaplan-Meier method and the survival curve was drawn,the difference between groups was compared by log-rank test.Results:Eighty-nine patients were included in this study,postoperative complications(Clavien-Dindo classification≥Ⅱ)within 30 d after operation occurred in 26 cases(29.2%),and severe complications(Clavien-Dindo classification≥Ⅲa)occurred in 8 cases(9.0%),including 3 cases of anastomotic leakage,1 case of abdominal bleeding,3 cases of respiratory dysfunction and 1 perioperative death due to pneumonia.Multivariate analysis showed that operation time>280 min(OR=3.409,95%CI:1.144-10.163,P=0.028)and the history of abdominal surgery(OR=4.888,95%CI:1.265-18.888,P=0.021)were independent risk factors for postoperative complications.The 3-year overall survival rate of patients with and without postoperative complications was 52.4%and 59.4%,respectively(P=0.355).The 3-year disease-free survival rate was 38.6%and 57.4%,respectively(P=0.400).Conclusions:Robotic gastrectomy for gastric cancer after neoadjuvant chemotherapy is safe and feasible.For patients with history of abdominal surgery and operation time>280 min,robotic gastrectomy for gastric cancer after neoadjuvant chemotherapy should be chosen carefully.