外科理论与实践 ›› 2021, Vol. 26 ›› Issue (01): 41-47.doi: 10.16139/j.1007-9610.2021.01.009

• 论著 • 上一篇    下一篇

胃癌腹膜转移病人腹腔化疗港并发症发生及危险因素分析

杨中印a, 李琛a, 刘文韬a, 施敏b, 吴珺玮b, 郑亚南a, 朱正伦a, 华子辰a, 倪震天a, 陆晟a, 燕敏a, 严超a(), 朱正纲a()   

  1. a.外科上海消化外科研究所,上海市胃肿瘤重点实验室,上海交通大学医学院附属瑞金医院,上海 200025
    b.肿瘤内科,上海消化外科研究所,上海市胃肿瘤重点实验室,上海交通大学医学院附属瑞金医院,上海 200025
  • 收稿日期:2020-11-23 出版日期:2021-01-25 发布日期:2022-07-28
  • 通讯作者: 严超,朱正纲 E-mail:yanchaosuper@163.com;zzg1954@hotmail.com
  • 基金资助:
    国家自然科学基金(81772518);上海交通大学医学院多中心临床研究项目(DLY201602)

Complications of implanted subcutaneous port for intraperitoneal chemotherapy in gastric cancer patients with peritoneal metastasis and analysis of risk factors of complications

YANG Zhongyina, LI Chena, LIU Wentaoa, SHI Minb, WU Junweib, ZHENG Yanana, ZHU Zhengluna, HUA Zichena, NI Zhentiana, LU Shenga, YAN Mina, YAN Chaoa(), ZHU Zhengganga()   

  1. a. Department of Surgery, Shanghai Institute of Digestive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    b. Department of Oncology, Ruijin Hospital, Shanghai Institute of Digestive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2020-11-23 Online:2021-01-25 Published:2022-07-28
  • Contact: YAN Chao,ZHU Zhenggang E-mail:yanchaosuper@163.com;zzg1954@hotmail.com

摘要:

目的:分析腹腔化疗港并发症发生及相关危险因素。方法:回顾性分析我院323例放置腹腔化疗港病人的临床资料,纳入261例胃癌腹膜转移病人。分析腹腔化疗港在胃癌腹膜转移病人腹腔化疗时发生的并发症及其危险因素。结果:261例中59例(22.6%)发生化疗港相关并发症。其中,皮下积液(25例,42.4%)和化疗港感染(16例,27.1%)是发生较多的并发症。其他是港体倾斜翻转(9例,15.3%),化疗港局部切口裂开(7例,11.9%),导管堵塞(1例,1.7%),和皮下转移(1例,1.7%)。化疗港并发症发生的中位时间为化疗港放置后3.0个月。结合Clavien-Dindo分级方法,将化疗港发生的并发症分为1~4个等级。ECOG 评分、血清白蛋白水平、置港流程优化及专业团队放置为化疗港并发症发生的独立危险因素(P<0.05)。ECOG 评分为唯一影响并发症分级的关联因素(P<0.05)。结论:腹腔化疗港在胃癌腹膜转移病人腹腔化疗中的应用安全可行,发生并发症可控。ECOG评分、血清白蛋白水平、置港方式是否优化及是否专业团队放置为化疗港并发症发生的独立危险因素。

关键词: 胃癌, 腹膜转移, 腹腔化疗, 紫杉醇, 化疗港并发症

Abstract:

Objective To analyze the port complications and risk factors associated with the port complications in gastric cancer patients with peritoneal metastasis. Methods The medical records of 323 patients with subcutaneous ports implantation for intraperitoneal chemotherapy were retrospectively analyzed and 261 gastric cancer patients with peritoneal metastasis were included. Port complications and risk factors associated with complications were analyzed. Results There were 59 (22.6%) cases with port complications associated with intraperitoneal chemotherapy in all included 261 cases. Subcutaneous effusion (25 cases, 42.4%) and port infection (16 cases, 27.1%) were the main complications, followed by port rotation (9 cases, 15.3%), partial port wound dehiscence (7 cases, 11.9%), catheter obstruction (1 case, 1.7%) and subcutaneous metastasis (1 case, 1.7%). The median period between port implantation and occurrence of complications was 3.0 months. Eastern Cooperative Oncology Group (ECOG) score, serum albumin, implantation management optimization and implantation specialized group were independent risk factors for port complications (P<0.05). ECOG score was the only factor that related to the grade of port complications (P<0.05). Conclusions Port implantation would be safe and feasible for gastric cancer patients with peritoneal metastasis who received intraperitoneal chemotherapy. ECOG score, serum albumin, implantation ma-nagement optimization and specialized group are independent risk factors associated with port complications.

Key words: Gastric cancer, Peritoneal metastasis, Intraperitoneal chemotherapy, Paclitaxel, Port complication

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