PDF(Pubmed)
Abstract：
OBJECTIVE: Textbook outcome is a comprehensive measure used to assess surgical quality and is increasingly being recognized as a valuable evaluation tool. Delta-shaped anastomosis (DA), an intracorporeal gastroduodenostomy, is a viable option for minimally invasive distal gastrectomy in patients with gastric cancer. This study aims to evaluate the surgical outcomes and calculate the textbook outcome of DA.
METHODS: In this retrospective study, the records of 4,902 patients who underwent minimally invasive distal gastrectomy for DA between 2009 and 2020 were reviewed. The data were categorized into three phases to analyze the trends over time. Surgical outcomes, including the operation time, length of post-operative hospital stay, and complication rates, were assessed, and the textbook outcome was calculated.
RESULTS: Among 4,505 patients, the textbook outcome is achieved in 3,736 (82.9%). Post-operative complications affect the textbook outcome the most significantly (91.9%). The highest textbook outcome is achieved in phase 2 (85.0%), which surpasses the rates of in phase 1 (81.7%) and phase 3 (82.3%). The post-operative complication rate within 30 d after surgery is 8.7%, and the rate of major complications exceeding the Clavien-Dindo classification grade 3 is 2.4%.
CONCLUSIONS: Based on the outcomes of a large dataset, DA can be considered safe and feasible for gastric cancer.
METHODS: In this retrospective study, the records of 4,902 patients who underwent minimally invasive distal gastrectomy for DA between 2009 and 2020 were reviewed. The data were categorized into three phases to analyze the trends over time. Surgical outcomes, including the operation time, length of post-operative hospital stay, and complication rates, were assessed, and the textbook outcome was calculated.
RESULTS: Among 4,505 patients, the textbook outcome is achieved in 3,736 (82.9%). Post-operative complications affect the textbook outcome the most significantly (91.9%). The highest textbook outcome is achieved in phase 2 (85.0%), which surpasses the rates of in phase 1 (81.7%) and phase 3 (82.3%). The post-operative complication rate within 30 d after surgery is 8.7%, and the rate of major complications exceeding the Clavien-Dindo classification grade 3 is 2.4%.
CONCLUSIONS: Based on the outcomes of a large dataset, DA can be considered safe and feasible for gastric cancer.
摘要：
目的：教科书结果是用于评估手术质量的综合指标，并且越来越被认为是一种有价值的评估工具。三角形吻合术(DA),胃十二指肠内造口术,是胃癌患者微创远端胃切除术的可行选择。本研究旨在评估手术结果并计算DA的教科书结果。
方法：在这项回顾性研究中，本研究回顾了2009~2020年间接受DA微创远端胃切除术的4,902例患者的记录.将数据分为三个阶段，以分析随时间的趋势。手术结果,包括手术时间，术后住院时间,和并发症发生率，被评估，并计算了教科书的结果。
结果：在4,505名患者中，在3,736（82.9％）中实现了教科书成果。术后并发症对教科书结局的影响最大（91.9％）。在第二阶段实现了最高的教科书成绩(85.0%)，超过第一阶段(81.7%)和第三阶段(82.3%)的比率。术后30d内并发症发生率为8.7%,超过Clavien-Dindo分级3级的主要并发症发生率为2.4%。
结论：基于大型数据集的结果，DA治疗胃癌是安全可行的。
方法：在这项回顾性研究中，本研究回顾了2009~2020年间接受DA微创远端胃切除术的4,902例患者的记录.将数据分为三个阶段，以分析随时间的趋势。手术结果,包括手术时间，术后住院时间,和并发症发生率，被评估，并计算了教科书的结果。
结果：在4,505名患者中，在3,736（82.9％）中实现了教科书成果。术后并发症对教科书结局的影响最大（91.9％）。在第二阶段实现了最高的教科书成绩(85.0%)，超过第一阶段(81.7%)和第三阶段(82.3%)的比率。术后30d内并发症发生率为8.7%,超过Clavien-Dindo分级3级的主要并发症发生率为2.4%。
结论：基于大型数据集的结果，DA治疗胃癌是安全可行的。
