PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to compare complication rates between pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) using Korean nationwide survey data and propensity score weighting (PSW). PPG preserves gastric function but may lead to more postoperative complications than DG.
RESULTS: We analyzed 9424 gastric cancer patients who underwent either DG (n = 9183) or PPG (n = 241). PSW balanced variables such as age, sex, TNM stage, comorbidities, ASA score, and surgical approach. Before PSW, 87.8% of DG patients and 87.1% of PPG patients had no complications (p = 0.053). Severe complications (Clavien-Dindo IIIa or higher) were more frequent in PPG (6.6%) than in DG (3.8%) (p = 0.039). After PSW, overall complication rates (p = 0.960) and severe complication rates (p = 0.574) were similar between groups. Incidence rates of anastomotic stricture and leakage were higher in PPG (2.9% and 1.7%) compared to DG (0.6% and 0.5%) (p = 0.001 and 0.036) before PSW, but these differences were not significant after PSW (p = 0.999 and 0.123).
CONCLUSIONS: The PSW-adjusted analysis indicates no significant difference in overall and severe complication rates between PPG and DG in gastric cancer patients.
RESULTS: We analyzed 9424 gastric cancer patients who underwent either DG (n = 9183) or PPG (n = 241). PSW balanced variables such as age, sex, TNM stage, comorbidities, ASA score, and surgical approach. Before PSW, 87.8% of DG patients and 87.1% of PPG patients had no complications (p = 0.053). Severe complications (Clavien-Dindo IIIa or higher) were more frequent in PPG (6.6%) than in DG (3.8%) (p = 0.039). After PSW, overall complication rates (p = 0.960) and severe complication rates (p = 0.574) were similar between groups. Incidence rates of anastomotic stricture and leakage were higher in PPG (2.9% and 1.7%) compared to DG (0.6% and 0.5%) (p = 0.001 and 0.036) before PSW, but these differences were not significant after PSW (p = 0.999 and 0.123).
CONCLUSIONS: The PSW-adjusted analysis indicates no significant difference in overall and severe complication rates between PPG and DG in gastric cancer patients.
摘要：
目的：本研究旨在使用韩国全国调查数据和倾向评分加权(PSW)比较保留幽门胃切除术(PPG)和远端胃切除术(DG)的并发症发生率。PPG可以保留胃功能，但可能比DG导致更多的术后并发症。
结果：我们分析了9424例接受DG（n=9183）或PPG（n=241）的胃癌患者。PSW平衡变量，如年龄，性别,TNM阶段,合并症,ASA得分,和手术方法。在PSW之前,87.8％的DG患者和87.1％的PPG患者没有并发症（p=0.053）。严重并发症（Clavien-DindoIIIa或更高）在PPG（6.6％）中的发生率高于DG（3.8％）（p=0.039）。PSW之后,两组间的总并发症发生率(p=0.960)和严重并发症发生率(p=0.574)相似.与PSW前的DG（0.6％和0.5％）相比，PPG的吻合口狭窄和渗漏的发生率更高（2.9％和1.7％）（p=0.001和0.036），但PSW后这些差异并不显著(p=0.999和0.123)。
结论：PSW校正分析表明，胃癌患者PPG和DG的总体和严重并发症发生率无显著差异。
结果：我们分析了9424例接受DG（n=9183）或PPG（n=241）的胃癌患者。PSW平衡变量，如年龄，性别,TNM阶段,合并症,ASA得分,和手术方法。在PSW之前,87.8％的DG患者和87.1％的PPG患者没有并发症（p=0.053）。严重并发症（Clavien-DindoIIIa或更高）在PPG（6.6％）中的发生率高于DG（3.8％）（p=0.039）。PSW之后,两组间的总并发症发生率(p=0.960)和严重并发症发生率(p=0.574)相似.与PSW前的DG（0.6％和0.5％）相比，PPG的吻合口狭窄和渗漏的发生率更高（2.9％和1.7％）（p=0.001和0.036），但PSW后这些差异并不显著(p=0.999和0.123)。
结论：PSW校正分析表明，胃癌患者PPG和DG的总体和严重并发症发生率无显著差异。
