有症状新型冠状病毒感染者感染后30天内行胃肠恶性肿瘤根治手术安全性的队列研究

赵旭东; 于志远; 马超; 周思欣; 刘娜; 乔治; 李沛雨

doi:10.12435/j.issn.2095-5227.2024.002

有症状新型冠状病毒感染者感染后30天内行胃肠恶性肿瘤根治手术安全性的队列研究

Safety of surgical resection of malignant gastrointestinal tumors in patients with symptoms of COVID-19 within 30 days after infection: A cohort study

摘要

摘要:
背景胃肠道肿瘤患者在感染新型冠状病毒后是否需要长时间推迟限期手术目前意见尚不统一。
目的探讨有症状的新冠病毒感染者在感染后30天内行胃肠恶性肿瘤根治手术的安全性。
方法采用队列研究，分析2022年11月1日至2023年1月16日于解放军总医院第一医学中心普通外科医学部行手术治疗的胃肠道肿瘤患者的临床资料，比较感染与未感染新冠病毒两组患者的并发症的发生率、并发症的严重程度。
结果感染组胃肠道肿瘤患者81例，对照组胃肠道肿瘤患者131例，两组在年龄、性别、体质指数(BMI)等基线资料，以及手术方式、手术时长、出血量、术后平均住院日、淋巴结检出数目、疫苗接种率等方面的差异均无统计学差异(P＞0.05)。并发症发生率(14.8%(12/81) vs 16.8%(22/131), P=0.703)和并发症严重程度(Clavien–Dindo分级：Ⅰ级/Ⅱ级/Ⅲa级/Ⅲb级)(2.5%、9.9%、4.9%和2.5% vs 3.8%、9.9%、7.6%和0.8%，P=0.721)等方面的差异亦无统计学意义。
结论有症状的新冠病毒感染者在感染后的30天内(术前新冠病毒核酸检测转阴)行胃肠道恶性肿瘤根治手术是安全的。

Abstract:
Background Whether patients with gastrointestinal malignancies who need timely surgery should postpone timely surgery for a long time after being infected with COVID-19 remains controversial.
Objective To evaluate the safety of surgical resection of malignant gastrointestinal tumors in patients with symptoms of COVID-19 within 30 days after infection.
Methods The clinical data and prognosis of patients with malignant gastrointestinal tumors who underwent surgery in the Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital from November 1, 2022 to January 16, 2023, were collected and analyzed retrospectively. The incidence of complications, severity of complications between the two groups were compared.
Results There were 81 patients in the infection group and 131 patients in the control group, and there were no statistically significant differences between the two groups in age, sex, body mass index (BMI), modus operandi, operative time, blood loss, length of postoperative hospital stay, number of harvested lymph nodes, or vaccination status(all P＞0.05). And no significant differences were found in complication probability (14.8%(12/81) vs 16.8%(22/131), P=0.703) and complication severity (Clavien‒Dindo classification: grade Ⅰ, grade Ⅱ, grade Ⅲa and grade Ⅲb) (2.5%, 9.9%, 4.9%和2.5% vs 3.8%, 9.9%, 7.6%, and 0.8%, P=0.721) between the two groups.
Conclusion The surgical resection of malignant gastrointestinal tumors in patients with symptoms of COVID-19 within 30 days after infection is safe.

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