文章：

细胞减灭术与腹腔热灌注化疗期间白蛋白渗漏水平与主要并发症相关

Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications

原文发布日期：19 August 2024

DOI: 10.3390/cancers16162874

类型: Article

开放获取: 是

英文摘要：

The clinical consequences of perioperative albumin extravasation accompanying major abdominal surgery remain underexplored. We retrospectively reviewed the data of patients who underwent cytoreductive surgery (CRS) and hyperthermic intraoperative peritoneal chemotherapy (HIPEC). Parameters of albumin kinetics, including serum albumin concentration decrease (∆Alb) and extravasated albumin level (Albshift), were assessed from surgery until postoperative day (POD) 3. Logistic regression analysis identified factors associated with major complications. The association of albumin kinetics with major complications was evaluated using receiver operating characteristic (ROC) curve analysis. Serum albumin levels decreased during surgery and subsequently increased. Of the 121 analyzed patients, 25 (21%) developed major complications. The ∆Alb and Albshiftduring surgery and on POD 3 were greater in patients who developed major complications than in those who did not (12 ± 12 vs. 6 ± 14,p= 0.032, and 127.5 (71.9) vs. 48.5 (44.9),p< 0.001, respectively). Perioperative ∆Alb and Albshiftwere associated with major complications. The areas under the ROC curve of Albshiftduring the 3 days post-surgery and Albshifton POD 3 were 0.843 and 0.910, respectively. Albshiftduring the 3 days post-surgery and Albshifton POD 3 were correlated with complications (p< 0.05). In conclusion, perioperative albumin loss was associated with major complications in patients undergoing CRS and HIPEC. Albshiftwas associated with serious complications.

摘要翻译： 

围手术期白蛋白外渗伴随重大腹部手术的临床后果仍未得到充分研究。我们回顾性分析了接受肿瘤细胞减灭术（CRS）和腹腔热灌注化疗（HIPEC）患者的数据。从手术开始至术后第3天（POD 3），评估了白蛋白动力学参数，包括血清白蛋白浓度下降值（∆Alb）和外渗白蛋白水平（Albshift）。通过逻辑回归分析确定了与主要并发症相关的因素，并采用受试者工作特征（ROC）曲线分析评估白蛋白动力学与主要并发症的关联性。血清白蛋白水平在术中下降，随后逐渐回升。在121例分析患者中，25例（21%）出现主要并发症。发生主要并发症的患者在术中及术后第3天的∆Alb和Albshift均显著高于未发生并发症者（分别为12 ± 12 vs. 6 ± 14，p=0.032；127.5 (71.9) vs. 48.5 (44.9)，p<0.001）。围手术期∆Alb和Albshift与主要并发症相关。术后3天内Albshift及术后第3天Albshift的ROC曲线下面积分别为0.843和0.910，且均与并发症显著相关（p<0.05）。综上所述，围手术期白蛋白丢失与接受CRS和HIPEC患者的主要并发症相关，其中Albshift与严重并发症具有显著关联。

原文链接：

Albumin Leakage Level during Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Is Associated with Major Complications