结直肠肛门外科2025，Vol.31Issue(4)：346-348,3.DOI:10.19668/j.cnki.issn1674-0491.2025.04.011
[评论]右半结肠癌择期切除与急诊切除术后结局:一项倾向性评分匹配分析
Outcomes after elective versus emergency resection for right-sided colon cancer:a propensity score-matched analysis
KERTZMAN B A J 1AMELUNG F J 1BURGHGRAEF T A 1祝伟杰 2李建男2
作者信息
- 2. 吉林大学第二医院结直肠及肛门外科 吉林长春 130021
- 折叠
摘要
Abstract
Background Previous studies reported similar complication rates,including anastomotic leakage,after elective and emergency surgery for right-sided colon cancer.This led to the consensus that emergency resection with primary anastomosis is safe.However,recent evidence suggests higher complication rates after emergency surgery,indicating that alternative strategies,such as a bridge to surgery,may be more suitable.Objective To assess whether complication rates,particularly anastomotic leakage,are higher after emergency resections compared to elective resections in patients with right-sided colon cancer.Design A retrospective cohort study using data from the Dutch ColoRectal Audit from 2010 to 2019.Settings Nationwide data from hospitals across the Netherlands.Patients Patients who underwent resec-tion for right-sided colon cancer(n=5 056 emergency resections matched 1:1 to elective resections using propensity score matching).Main Outcome Measures Incidence of anastomotic leakage,90-day complication rates,and mortality rates after elective versus emergency surgery for right-sided colon cancer.Results After matching,no significant baseline differences remained.There was no significant difference in anastomotic leakage rates.However,the mortality rate was twice as high in the emergency group(9.4％vs.4.2％,P＜0.001),and the 90-day complication rate was also higher(41.7％vs.33.0％,P＜0.001).Limitations Minimal missing data were handled with multiple imputation.Although propen-sity score matching was used,bias from unknown confounders may persist.The emergency group included more high-risk patients,potentially influencing outcomes.Conclusions Emergency resections for right-sided colon cancer are associ-ated with higher complication and mortality rates compared to elective surgery.A bridge-to-surgery approach could re-duce these risks by converting emergency cases to elective procedures.Further research is needed to validate these find-ings.关键词
桥接手术/择期切除/急诊切除/倾向性评分匹配/右半结肠癌/短期结局Key words
bridge to surgery/elective resection/emergency surgery/propensity score matching/right-sided colon cancer/short-term outcomes分类
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KERTZMAN B A J,AMELUNG F J,BURGHGRAEF T A,祝伟杰,李建男..[评论]右半结肠癌择期切除与急诊切除术后结局:一项倾向性评分匹配分析[J].结直肠肛门外科,2025,31(4):346-348,3.
