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.	張龍龍, 樊強, 顧越雷, 等. 普外科非計劃再手術患者預后轉歸的相關分析. 中國普外基礎與臨床雜志, 2018, 25(3): 317-322.
3.	王相巖, 干寧. 婦產科非計劃再次手術臨床分析. 安徽醫科大學, 2017.
4.	羅會強, 李念, 吳侃, 等. 非計劃再手術研究現狀及趨勢. 華西醫學, 2017, 32(12): 1977-1979.
5.	宋萍, 李秋, 李映良, 等. 住院患者非計劃再手術原因分析及控制措施. 現代醫院管理, 2015, 13(3): 5-7, 71.
6.	董穎. 消化道惡性腫瘤流行病學特征與發病現狀分析. 醫學綜述, 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.	趙佳, 徐長妍, 劉玉霞, 等. 某大學三所附屬醫院手術分級管理現況調查. 中國病案, 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. 普外科非計劃再手術原因分析與防治對策. 川北醫學院學報, 2016, 31(1): 104-107.
14.	袁迅, 劉麗, 馬聰. 基于病歷檔案的 138 例非計劃再次手術原因分析及對策研究. 中國衛生產業, 2018, 15(6): 177-178, 186.
15.	于瑾, 王東, 宋景晨, 等. 北京市某醫院 79 例非計劃再手術原因與改進措施. 中國醫療管理科學, 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.	張繼如, 王志強, 季永, 等. 不同危險分層老年高血壓患者圍手術期心血管事件風險分析. 中華高血壓雜志, 2016, 24(4): 400.
18.	李襄軍, 范小云, 姚潔, 等. 2 型糖尿病住院患者合并惡性腫瘤的分布情況及相關危險因素分析. 腫瘤預防與治療, 2015, 28(3): 127-130.
19.	張銀芳. 切口綜合處理對剖宮產術后切口愈合的促進效果分析. 中國美容醫學, 2015, 24(11): 18-21.
20.	樊強, 張龍龍, 顧越雷, 等. 載藥納米膜預防膽囊切除術后腹腔粘連的實驗研究. 中國普外基礎與臨床雜志, 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.	鄧金和, 賀繁榮, 招偉賢. 胃腸手術患者術前貧血與術后并發癥的關系. 廣東醫學, 2017, 38(6): 900-902.
27.	陳政, 張季文. 非計劃再手術管理對醫療糾紛防范的實踐體會. 現代醫院, 2017, 17(7): 944-946, 949.
28.	于銘, 曹振廣. 新形勢下醫療糾紛防范的理性思考和對策. 中國醫院, 2007, 11(11): 47-49.
29.	張曉潔, 賈慧民, 王瑩, 等. 腫瘤專科醫院非計劃再次手術與醫療糾紛關系研究. 新疆醫學, 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. 張龍龍, 樊強, 顧越雷, 等. 普外科非計劃再手術患者預后轉歸的相關分析. 中國普外基礎與臨床雜志, 2018, 25(3): 317-322.
3. 王相巖, 干寧. 婦產科非計劃再次手術臨床分析. 安徽醫科大學, 2017.
4. 羅會強, 李念, 吳侃, 等. 非計劃再手術研究現狀及趨勢. 華西醫學, 2017, 32(12): 1977-1979.
5. 宋萍, 李秋, 李映良, 等. 住院患者非計劃再手術原因分析及控制措施. 現代醫院管理, 2015, 13(3): 5-7, 71.
6. 董穎. 消化道惡性腫瘤流行病學特征與發病現狀分析. 醫學綜述, 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. 趙佳, 徐長妍, 劉玉霞, 等. 某大學三所附屬醫院手術分級管理現況調查. 中國病案, 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. 普外科非計劃再手術原因分析與防治對策. 川北醫學院學報, 2016, 31(1): 104-107.
14. 袁迅, 劉麗, 馬聰. 基于病歷檔案的 138 例非計劃再次手術原因分析及對策研究. 中國衛生產業, 2018, 15(6): 177-178, 186.
15. 于瑾, 王東, 宋景晨, 等. 北京市某醫院 79 例非計劃再手術原因與改進措施. 中國醫療管理科學, 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. 張繼如, 王志強, 季永, 等. 不同危險分層老年高血壓患者圍手術期心血管事件風險分析. 中華高血壓雜志, 2016, 24(4): 400.
18. 李襄軍, 范小云, 姚潔, 等. 2 型糖尿病住院患者合并惡性腫瘤的分布情況及相關危險因素分析. 腫瘤預防與治療, 2015, 28(3): 127-130.
19. 張銀芳. 切口綜合處理對剖宮產術后切口愈合的促進效果分析. 中國美容醫學, 2015, 24(11): 18-21.
20. 樊強, 張龍龍, 顧越雷, 等. 載藥納米膜預防膽囊切除術后腹腔粘連的實驗研究. 中國普外基礎與臨床雜志, 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. 鄧金和, 賀繁榮, 招偉賢. 胃腸手術患者術前貧血與術后并發癥的關系. 廣東醫學, 2017, 38(6): 900-902.
27. 陳政, 張季文. 非計劃再手術管理對醫療糾紛防范的實踐體會. 現代醫院, 2017, 17(7): 944-946, 949.
28. 于銘, 曹振廣. 新形勢下醫療糾紛防范的理性思考和對策. 中國醫院, 2007, 11(11): 47-49.
29. 張曉潔, 賈慧民, 王瑩, 等. 腫瘤專科醫院非計劃再次手術與醫療糾紛關系研究. 新疆醫學, 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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