지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.2
- 발행연도
- 2019.8
- 수록면
- 65 - 73 (9page)
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초록· 키워드
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Purpose: Postoperative complications (PCs) after gastrectomy are associated with readmission and longer hospital stay. This study aimed to determine the role of CRP as an early predictor of PCs and a reliable discharge indicator after gastrectomy.
Methods: Clinicopathologic data and PCs of 613 patients who underwent gastrectomy for gastric cancer in 2015–2016 were retrospectively analyzed, including consecutive blood samples for CRP obtained preoperatively, at the operative day, and postoperatively. Following the Clavien-Dindo classification, the patients were divided into a group with major PCs and a group with minor/no PCs. Diagnostic accuracy was determined by the area under the receiver operating characteristic curve (AUC). Clinical factors related to major PCs were identified using univariate and multivariate logistic regression analyses.
Results: PCs occurred in 89 patients (14.5%). The most significant predictive factor for major PCs was a CRP concentration reduction rate of ≤38.1% (AUC, 0.82; sensitivity, 76.4%; specificity, 76.1%) between postoperative day (POD) 3 and 5 (R5), followed by ≤11.1% (AUC, 0.75; sensitivity, 73%; specificity, 76%) between POD 2 and 3 (R4). When both factors were applied (R4 ≤ 11.1% and R5 ≤ 38.1%), the specificity was 91.6%; when only one condition was satisfied (R4 ≤ 11.1% or R5 ≤ 38.1%), the sensitivity was 91%.
Conclusion: CRP concentration reduction rates between POD 3 and 5 and between POD 2 and 3 were the best combination factors to predict PCs and indicate a safe discharge after gastrectomy for gastric cancer.
Methods: Clinicopathologic data and PCs of 613 patients who underwent gastrectomy for gastric cancer in 2015–2016 were retrospectively analyzed, including consecutive blood samples for CRP obtained preoperatively, at the operative day, and postoperatively. Following the Clavien-Dindo classification, the patients were divided into a group with major PCs and a group with minor/no PCs. Diagnostic accuracy was determined by the area under the receiver operating characteristic curve (AUC). Clinical factors related to major PCs were identified using univariate and multivariate logistic regression analyses.
Results: PCs occurred in 89 patients (14.5%). The most significant predictive factor for major PCs was a CRP concentration reduction rate of ≤38.1% (AUC, 0.82; sensitivity, 76.4%; specificity, 76.1%) between postoperative day (POD) 3 and 5 (R5), followed by ≤11.1% (AUC, 0.75; sensitivity, 73%; specificity, 76%) between POD 2 and 3 (R4). When both factors were applied (R4 ≤ 11.1% and R5 ≤ 38.1%), the specificity was 91.6%; when only one condition was satisfied (R4 ≤ 11.1% or R5 ≤ 38.1%), the sensitivity was 91%.
Conclusion: CRP concentration reduction rates between POD 3 and 5 and between POD 2 and 3 were the best combination factors to predict PCs and indicate a safe discharge after gastrectomy for gastric cancer.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (27)
참고문헌 신청
Jeong O / 2015 / Analysis of 30-day postdischarge morbidity and readmission after radical gastrectomy for gastric carcinoma: a single-center study of 2107 patients with prospective data / Medicine(Baltimore) 94:e259
Kim EY / 2017 / C-reactive protein can be an early predictor of postoperative complications after gastrectomy for gastric cancer / Surg Endosc 31:445~454
Kim HH / 2010 / Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer : an interim report--a phase III multicenter, prospective, randomized Trial(KLASS Trial) / Ann Surg 251:417~420
Cuschieri A / 1996 / Postoperative morbidity and mortality after D1 and D2resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group / Lancet 347:995~999
Sano T / 2004 / Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy--Japan Clinical Oncology Group study 9501 / J Clin Oncol 22:2767~2773
Kim EY / 2017 / C-reactive protein can be an early predictor of postoperative complications after gastrectomy for gastric cancer / Surg Endosc 31:445~454
Kim HH / 2010 / Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer : an interim report--a phase III multicenter, prospective, randomized Trial(KLASS Trial) / Ann Surg 251:417~420
Cuschieri A / 1996 / Postoperative morbidity and mortality after D1 and D2resections for gastric cancer: preliminary results of the MRC randomised controlled surgical trial. The Surgical Cooperative Group / Lancet 347:995~999
Sano T / 2004 / Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy--Japan Clinical Oncology Group study 9501 / J Clin Oncol 22:2767~2773
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UCI(KEPA) : I410-ECN-0101-2019-514-000942521