Correlation analysis of risk factors and prognosis of unplanned reoperation in patients with malignant tumors of digestive tract_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Feng ¹ , ZHANG Longlong ² ,  FAN Qiang ¹ , FAN Xiao ¹ , CHEN Hongwei ¹ , WU Guangbo ¹ ,  YANG Sunhu ¹

1. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, P. R. China;
2. Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201900, P. R. China;

Corresponding author：

FAN Qiang, Email: 13472665251@163.com; YANG Sunhu, Email: yangsh06@126.com

Keywords：

malignant tumors of digestive tract; unplanned reoperation; risk factor

DOI：

10.7507/1007-9424.201808058

Video：

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Objective To explore risk factors and prognosis of unplanned reoperation in patients with malignant tumors of digestive tract. Methods The clinical data of patients with malignant tumors of digestive tract underwent unplanned reoperation who treated in the Department of General Surgery, the Northern District of the Shanghai Ninth People’s Hospital from January 2014 to December 2017 were retrospectively collected, and each operation was matched in a ratio of 1∶3 as a case-conontrol study object. The risk factors and prognosis of unplanned reoperation were analyzed by the basic information, surgical related informations, and postoperative relevant informations. Results There were 33 cases of unplanned reoperation in the 588 patients with malignant tumors of digestive tract treated surgically, 8 cases died after the unplanned reoperation. The analysis results showed that the basic diseases, history of previous abdominal surgery, preoperative anemia, the first operative time >4 h and intraoperative blood loss ≥400 mL were the independent risk factors of the unplanned reoperations (P<0.050); the basic diseases, unplanned preoperative hemoglobin <90 g/L and intraoperative blood loss ≥400 mL were the independent factors of death for patients with unplanned reoperation (P<0.050). Conclusions Effective intervention on independent risk factors associated with unplanned reoperation in patients with digestive tract malignant tumors can reduce incidence of unplanned reoperation in future and improve prognosis.

Citation： LI Feng, ZHANG Longlong, FAN Qiang, FAN Xiao, CHEN Hongwei, WU Guangbo, YANG Sunhu. Correlation analysis of risk factors and prognosis of unplanned reoperation in patients with malignant tumors of digestive tract. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(1): 49-55. doi: 10.7507/1007-9424.201808058 Copy

1.	Lin Y, Meguid RA, Hosokawa PW, et al. An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. Am J Surg, 2017, 214(1): 1-6.
2.	张龙龙, 樊强, 顾越雷, 等. 普外科非计划再手术患者预后转归的相关分析. 中国普外基础与临床杂志, 2018, 25(3): 317-322.
3.	王相岩, 干宁. 妇产科非计划再次手术临床分析. 安徽医科大学, 2017.
4.	罗会强, 李念, 吴侃, 等. 非计划再手术研究现状及趋势. 华西医学, 2017, 32(12): 1977-1979.
5.	宋萍, 李秋, 李映良, 等. 住院患者非计划再手术原因分析及控制措施. 现代医院管理, 2015, 13(3): 5-7, 71.
6.	董颖. 消化道恶性肿瘤流行病学特征与发病现状分析. 医学综述, 2014, 20(3): 429-431.
7.	Rubió-Casadevall J, Borràs JL, Carmona C, et al. Temporal trends of incidence and survival of sarcoma of digestive tract including gastrointestinal stromal tumours (GIST) in two areas of the north-east of Spain in the period 1981–2005: a population-based study. Clin Transl Oncol, 2014, 16(7): 660-667.
8.	Bolmstrand B, Nilsson PJ, Holm T, et al. Patterns of complications following urinary tract reconstruction after multivisceral surgery in colorectal and anal cancer. Eur J Surg Oncol, 2018, 44(10): 1513-1517.
9.	赵佳, 徐长妍, 刘玉霞, 等. 某大学三所附属医院手术分级管理现况调查. 中国病案, 2015, 16(2): 18-20.
10.	Visnjevac O, Davari-Farid S, Lee J, et al. The effect of adding functional classification to ASA status for predicting 30-day mortality. Anesth Analg, 2015, 121(1): 110-116.
11.	Rama-Maceiras P, Rey-Rilo T, Moreno-Lopez E, et al. Unplanned surgical reoperations in a tertiary hospital: perioperative mortality and associated risk factors. Eur J Anaesthesiol, 2011, 28(1): 10-15.
12.	Guevara OA, Rubio-Romero JA, Ruiz-Parra AI. Unplanned reoperations: is emergency surgery a risk factor? A cohort study. J Surg Res, 2013, 182(1): 11-16.
13.	柏宇. 普外科非计划再手术原因分析与防治对策. 川北医学院学报, 2016, 31(1): 104-107.
14.	袁迅, 刘丽, 马聪. 基于病历档案的 138 例非计划再次手术原因分析及对策研究. 中国卫生产业, 2018, 15(6): 177-178, 186.
15.	于瑾, 王东, 宋景晨, 等. 北京市某医院 79 例非计划再手术原因与改进措施. 中国医疗管理科学, 2016, 6(6): 5-9.
16.	Lyu HG, Sharma G, Brovman EY, et al. Unplanned reoperation after hepatectomy: an analysis of risk factors and outcomes. HPB (Oxford), 2018, 20(7): 591-596.
17.	张继如, 王志强, 季永, 等. 不同危险分层老年高血压患者围手术期心血管事件风险分析. 中华高血压杂志, 2016, 24(4): 400.
18.	李襄军, 范小云, 姚洁, 等. 2 型糖尿病住院患者合并恶性肿瘤的分布情况及相关危险因素分析. 肿瘤预防与治疗, 2015, 28(3): 127-130.
19.	张银芳. 切口综合处理对剖宫产术后切口愈合的促进效果分析. 中国美容医学, 2015, 24(11): 18-21.
20.	樊强, 张龙龙, 顾越雷, 等. 载药纳米膜预防胆囊切除术后腹腔粘连的实验研究. 中国普外基础与临床杂志, 2017, 24(12): 1468-1472.
21.	Aydin OU, KarakasDO, Hazer B, et al. Anti-adhesive effects of argan oil on postoperative peritoneal adhesions. Int Med J, 2018, 7(3): 557-560.
22.	Zhura AV, Tratsyak SI, Khryshchanovich VJ, et al. Experimental model of peritoneal adhesion. Novosti Khirurgii, 2017, 25(4): 333-339.
23.	Chandra A, Mangam S, Marzouk D. A review of risk scoring systems utilised in patients undergoing gastrointestinal surgery. J Gastrointest Surg, 2009, 13(8): 1529-1538.
24.	Kansagra AJ, Stefan MS. Preoperative anemia: evaluation and treatment. Anesthesiol Clin, 2016, 34(1): 127-141.
25.	Liu L, Liu L, Liang LC, et al. Impact of preoperative anemia on perioperative outcomes in patients undergoing elective colorectal surgery. Gastroenterol Res Pract, 2018, 2018: 2417028.
26.	邓金和, 贺繁荣, 招伟贤. 胃肠手术患者术前贫血与术后并发症的关系. 广东医学, 2017, 38(6): 900-902.
27.	陈政, 张季文. 非计划再手术管理对医疗纠纷防范的实践体会. 现代医院, 2017, 17(7): 944-946, 949.
28.	于铭, 曹振广. 新形势下医疗纠纷防范的理性思考和对策. 中国医院, 2007, 11(11): 47-49.
29.	张晓洁, 贾慧民, 王莹, 等. 肿瘤专科医院非计划再次手术与医疗纠纷关系研究. 新疆医学, 2015, 45(12): 1774-1776.

1. Lin Y, Meguid RA, Hosokawa PW, et al. An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. Am J Surg, 2017, 214(1): 1-6.
2. 张龙龙, 樊强, 顾越雷, 等. 普外科非计划再手术患者预后转归的相关分析. 中国普外基础与临床杂志, 2018, 25(3): 317-322.
3. 王相岩, 干宁. 妇产科非计划再次手术临床分析. 安徽医科大学, 2017.
4. 罗会强, 李念, 吴侃, 等. 非计划再手术研究现状及趋势. 华西医学, 2017, 32(12): 1977-1979.
5. 宋萍, 李秋, 李映良, 等. 住院患者非计划再手术原因分析及控制措施. 现代医院管理, 2015, 13(3): 5-7, 71.
6. 董颖. 消化道恶性肿瘤流行病学特征与发病现状分析. 医学综述, 2014, 20(3): 429-431.
7. Rubió-Casadevall J, Borràs JL, Carmona C, et al. Temporal trends of incidence and survival of sarcoma of digestive tract including gastrointestinal stromal tumours (GIST) in two areas of the north-east of Spain in the period 1981–2005: a population-based study. Clin Transl Oncol, 2014, 16(7): 660-667.
8. Bolmstrand B, Nilsson PJ, Holm T, et al. Patterns of complications following urinary tract reconstruction after multivisceral surgery in colorectal and anal cancer. Eur J Surg Oncol, 2018, 44(10): 1513-1517.
9. 赵佳, 徐长妍, 刘玉霞, 等. 某大学三所附属医院手术分级管理现况调查. 中国病案, 2015, 16(2): 18-20.
10. Visnjevac O, Davari-Farid S, Lee J, et al. The effect of adding functional classification to ASA status for predicting 30-day mortality. Anesth Analg, 2015, 121(1): 110-116.
11. Rama-Maceiras P, Rey-Rilo T, Moreno-Lopez E, et al. Unplanned surgical reoperations in a tertiary hospital: perioperative mortality and associated risk factors. Eur J Anaesthesiol, 2011, 28(1): 10-15.
12. Guevara OA, Rubio-Romero JA, Ruiz-Parra AI. Unplanned reoperations: is emergency surgery a risk factor? A cohort study. J Surg Res, 2013, 182(1): 11-16.
13. 柏宇. 普外科非计划再手术原因分析与防治对策. 川北医学院学报, 2016, 31(1): 104-107.
14. 袁迅, 刘丽, 马聪. 基于病历档案的 138 例非计划再次手术原因分析及对策研究. 中国卫生产业, 2018, 15(6): 177-178, 186.
15. 于瑾, 王东, 宋景晨, 等. 北京市某医院 79 例非计划再手术原因与改进措施. 中国医疗管理科学, 2016, 6(6): 5-9.
16. Lyu HG, Sharma G, Brovman EY, et al. Unplanned reoperation after hepatectomy: an analysis of risk factors and outcomes. HPB (Oxford), 2018, 20(7): 591-596.
17. 张继如, 王志强, 季永, 等. 不同危险分层老年高血压患者围手术期心血管事件风险分析. 中华高血压杂志, 2016, 24(4): 400.
18. 李襄军, 范小云, 姚洁, 等. 2 型糖尿病住院患者合并恶性肿瘤的分布情况及相关危险因素分析. 肿瘤预防与治疗, 2015, 28(3): 127-130.
19. 张银芳. 切口综合处理对剖宫产术后切口愈合的促进效果分析. 中国美容医学, 2015, 24(11): 18-21.
20. 樊强, 张龙龙, 顾越雷, 等. 载药纳米膜预防胆囊切除术后腹腔粘连的实验研究. 中国普外基础与临床杂志, 2017, 24(12): 1468-1472.
21. Aydin OU, KarakasDO, Hazer B, et al. Anti-adhesive effects of argan oil on postoperative peritoneal adhesions. Int Med J, 2018, 7(3): 557-560.
22. Zhura AV, Tratsyak SI, Khryshchanovich VJ, et al. Experimental model of peritoneal adhesion. Novosti Khirurgii, 2017, 25(4): 333-339.
23. Chandra A, Mangam S, Marzouk D. A review of risk scoring systems utilised in patients undergoing gastrointestinal surgery. J Gastrointest Surg, 2009, 13(8): 1529-1538.
24. Kansagra AJ, Stefan MS. Preoperative anemia: evaluation and treatment. Anesthesiol Clin, 2016, 34(1): 127-141.
25. Liu L, Liu L, Liang LC, et al. Impact of preoperative anemia on perioperative outcomes in patients undergoing elective colorectal surgery. Gastroenterol Res Pract, 2018, 2018: 2417028.
26. 邓金和, 贺繁荣, 招伟贤. 胃肠手术患者术前贫血与术后并发症的关系. 广东医学, 2017, 38(6): 900-902.
27. 陈政, 张季文. 非计划再手术管理对医疗纠纷防范的实践体会. 现代医院, 2017, 17(7): 944-946, 949.
28. 于铭, 曹振广. 新形势下医疗纠纷防范的理性思考和对策. 中国医院, 2007, 11(11): 47-49.
29. 张晓洁, 贾慧民, 王莹, 等. 肿瘤专科医院非计划再次手术与医疗纠纷关系研究. 新疆医学, 2015, 45(12): 1774-1776.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Correlation analysis of risk factors and prognosis of unplanned reoperation in patients with malignant tumors of digestive tract

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