지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.90 No.3
- 발행연도
- 2016.2
- 수록면
- 157 - 163 (7page)
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초록· 키워드
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Purpose: A duodenal stump fistula is one of the most severe complications after gastrectomy for gastric cancer. We aimed to analyze the risk factors for this problem, and to identify the methods used for its prevention and management.
Methods: We retrospectively reviewed the clinical data of 716 consecutive patients who underwent curative gastrectomy with a duodenal stump for gastric cancer between 2008 and 2013.
Results: A duodenal stump fistula occurred in 16 patients (2.2%) and there were 2 deaths in this group. Univariate analysis revealed age >60 years (odds ratio [OR], 3.09; 95% confidence interval [CI], 0.99–9.66), multiple comorbidities (OR, 4.23; 95% CI, 1.50–11.92), clinical T stage (OR, 2.91; 95% CI, 1.045-8.10), and gastric outlet obstruction (OR, 8.64; 95% CI, 2.61–28.61) to be significant factors for developing a duodenal stump fistula. Multivariate analysis identified multiple comorbidities (OR, 3.92; 95% CI, 1.30–11.80) and gastric outlet obstruction (OR, 5.62; 95% CI, 1.45–21.71) as predictors of this complication.
Conclusion: Multiple comorbidities and gastric outlet obstruction were the main risk factors for a duodenal stump fistula. Therefore, preventive methods and aggressive management should be applied for patients at high risk.
Methods: We retrospectively reviewed the clinical data of 716 consecutive patients who underwent curative gastrectomy with a duodenal stump for gastric cancer between 2008 and 2013.
Results: A duodenal stump fistula occurred in 16 patients (2.2%) and there were 2 deaths in this group. Univariate analysis revealed age >60 years (odds ratio [OR], 3.09; 95% confidence interval [CI], 0.99–9.66), multiple comorbidities (OR, 4.23; 95% CI, 1.50–11.92), clinical T stage (OR, 2.91; 95% CI, 1.045-8.10), and gastric outlet obstruction (OR, 8.64; 95% CI, 2.61–28.61) to be significant factors for developing a duodenal stump fistula. Multivariate analysis identified multiple comorbidities (OR, 3.92; 95% CI, 1.30–11.80) and gastric outlet obstruction (OR, 5.62; 95% CI, 1.45–21.71) as predictors of this complication.
Conclusion: Multiple comorbidities and gastric outlet obstruction were the main risk factors for a duodenal stump fistula. Therefore, preventive methods and aggressive management should be applied for patients at high risk.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (21)
참고문헌 신청
Rossi JA, Sollenberger LL, Rege RV, Glenn J, Joehl RJ. External duodenal fistula: causes, complications, and treatment. Arch Surg 1986;121:908-12.
Tarazi R, Coutsoftides T, Steiger E, Fazio VW. Gastric and duodenal cutaneous fistulas. World J Surg 1983;7:463-73.
Edmunds H Jr, Williams GM, Welch CE. External fistulas arising from the gastrointestinal tract. And prospective overview. 1960. Nutrition 2003;19:182-6.
Cozzaglio L, Coladonato M, Biffi R, Coniglio A, Corso V, Dionigi P, et al. Duodenal fistula after elective gastrectomy for malignant disease : an italian retrospective multicenter study. J Gastrointest Surg 2010;14:805-11.
Orsenigo E, Bissolati M, Socci C, Chiari D, Muffatti F, Nifosi J, et al. Duodenal stump fistula after gastric surgery for malignancies: a retrospective analysis of risk factors in a single centre experience. Gastric Cancer 2014;17:733-44.
Tarazi R, Coutsoftides T, Steiger E, Fazio VW. Gastric and duodenal cutaneous fistulas. World J Surg 1983;7:463-73.
Edmunds H Jr, Williams GM, Welch CE. External fistulas arising from the gastrointestinal tract. And prospective overview. 1960. Nutrition 2003;19:182-6.
Cozzaglio L, Coladonato M, Biffi R, Coniglio A, Corso V, Dionigi P, et al. Duodenal fistula after elective gastrectomy for malignant disease : an italian retrospective multicenter study. J Gastrointest Surg 2010;14:805-11.
Orsenigo E, Bissolati M, Socci C, Chiari D, Muffatti F, Nifosi J, et al. Duodenal stump fistula after gastric surgery for malignancies: a retrospective analysis of risk factors in a single centre experience. Gastric Cancer 2014;17:733-44.
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UCI(KEPA) : I410-ECN-0101-2016-514-002640595