JAMA surgery:习惯性术前膳食纤维摄入与结直肠癌手术后并发症的相关性

2021-06-27 MedSci原创 MedSci原创

在西方国家,手术是大多数结直肠癌 (CRC) 患者的最终治疗方式,但是肿瘤切除后可能会出现严重的并发症,如吻合口漏、感染或肠梗阻。

      在西方国家,手术是大多数结直肠癌 (CRC) 患者的最终治疗方式,但是肿瘤切除后可能会出现严重的并发症,如吻合口漏、感染或肠梗阻,发生率大概在 15% 至 50%之间。新的研究证据表明肠道健康受损也可能与术后并发症的风险有关。作为改善肠道健康的膳食纤维摄入量与关于胃肠手术后并发症的风险目前还没有研究进行讨论。本项研究旨在探讨术前膳食纤维摄入量与结直肠癌术后并发症风险的相关性。

 

      本队列研究使用了来自结肠直肠纵向观察性研究 (COLON) 研究的临床数据,该研究在 2010 年 8 月至 2010 年期间从荷兰 11 家医院招募了大量结直肠癌成年患者。大部分患者均是接受了择期腹部手术的 I 至 IV 期结直肠癌患者。研究人员使用 204 项食物频率问卷在诊断时评估习惯性膳食纤维摄入量。主要观察结果是结直肠癌术后 30 d 内发生的并发症、手术并发症及吻合口瘘的情况。使用逻辑回归分析评估纤维摄入量与术后并发症风险之间的关联。

 

      在纳入分析的 1399 名患者中,中位年龄为 66 岁,896 名 (64%) 为男性。397 名患者(28%)没有发生术后并发症,235 名患者(17%)发生手术并发症。在 1237 名进行吻合术的患者中,67 名 (5%) 出现了吻合口漏。较高的膳食纤维摄入量(每天每 10 克)与任何并发症(比值比 [OR],0.75;95% CI,0.62-0.92)和手术并发症(OR,0.76;95% CI,0.60 -0.97)的发生率较低有关,而未发现与吻合口漏相关(OR,0.97;95% CI,0.66-1.43)。在女性中,较高的膳食摄入量能降低并发症相关的发病风险(OR,0.64;95% CI,0.44-0.94),而男性之间没有则没有这样的相关性(OR,0.79;95% CI,0.63-1.01)。

图:膳食纤维对于术后并发症的影响

      本项研究通过大样本人群研究发现手术前较高的习惯性膳食纤维摄入量与结直肠癌患者术后并发症的风险较低相关。在未来接受结直肠癌手术的患者的康复计划中,临床医生可以考虑增加术前膳食纤维的摄入量。

 

 

原始出处:

Dieuwertje E. Kok. Et al. Association of Habitual Preoperative Dietary Fiber Intake With Complications After Colorectal Cancer Surgery. JAMA surgery.2021.

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    2022-04-14 丁鹏鹏
  4. [GetPortalCommentsPageByObjectIdResponse(id=1837958, encodeId=3774183e958ca, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Apr 17 21:46:01 CST 2022, time=2022-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766661, encodeId=1b4c1e66661a2, content=<a href='/topic/show?id=e5b1e86980c' target=_blank style='color:#2F92EE;'>#结直肠癌手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78698, encryptionId=e5b1e86980c, topicName=结直肠癌手术)], attachment=null, authenticateStatus=null, createdAvatar=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Wed Apr 27 12:46:01 CST 2022, time=2022-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350446, encodeId=0bba13504468c, content=<a href='/topic/show?id=224a85904ad' target=_blank style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453535, 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createdName=linne322, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036703, encodeId=a0371036e0356, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun Jun 27 12:46:01 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1837958, encodeId=3774183e958ca, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Apr 17 21:46:01 CST 2022, time=2022-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766661, encodeId=1b4c1e66661a2, content=<a href='/topic/show?id=e5b1e86980c' target=_blank style='color:#2F92EE;'>#结直肠癌手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78698, encryptionId=e5b1e86980c, topicName=结直肠癌手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=422337851133, createdName=ms6279672939590805, createdTime=Tue Mar 29 03:46:01 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758335, encodeId=b19a1e583355b, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Thu Apr 14 21:46:01 CST 2022, time=2022-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021712, encodeId=38082021e120c, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Wed Apr 27 12:46:01 CST 2022, time=2022-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350446, encodeId=0bba13504468c, content=<a href='/topic/show?id=224a85904ad' target=_blank style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453535, 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createdName=linne322, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036703, encodeId=a0371036e0356, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun Jun 27 12:46:01 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1837958, encodeId=3774183e958ca, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Sun Apr 17 21:46:01 CST 2022, time=2022-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1766661, encodeId=1b4c1e66661a2, content=<a href='/topic/show?id=e5b1e86980c' target=_blank style='color:#2F92EE;'>#结直肠癌手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78698, encryptionId=e5b1e86980c, topicName=结直肠癌手术)], attachment=null, authenticateStatus=null, createdAvatar=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Wed Apr 27 12:46:01 CST 2022, time=2022-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1350446, encodeId=0bba13504468c, content=<a href='/topic/show?id=224a85904ad' target=_blank style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453535, encodeId=10c314535357c, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466274, encodeId=908314662e459, content=<a href='/topic/show?id=afda85920c3' target=_blank style='color:#2F92EE;'>#膳食纤维摄入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85920, encryptionId=afda85920c3, topicName=膳食纤维摄入)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dea96793953, createdName=linne322, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036703, encodeId=a0371036e0356, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun Jun 27 12:46:01 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
    2022-04-27 chg121
  7. 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createdName=linne322, createdTime=Tue Jun 29 00:46:01 CST 2021, time=2021-06-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036703, encodeId=a0371036e0356, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sun Jun 27 12:46:01 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
    2021-06-29 zhaojie88
  8. 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  9. 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    2021-06-27 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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结直肠癌(CRC)是美国癌症死亡的第三大主要原因,每年因CRC死亡的患者达50,000多名。

Clinical Nutrition:加工肉的摄入量与结直肠癌的风险相关

加工肉类和高钠摄入在西方饮食中很常见,什么是加工肉类,国际癌症研究机构是这样解释的:所有经过熏、腌、风干或用其他方式处理的为了增加风味以及长久保存的肉类。

Lancet Oncol:腹腔镜右结肠癌切除术,CME VS. D2切除术的短期效果

右结肠癌行淋巴结清扫术是否会增加围手术期并发症或提高生存率仍有争议。RELARC研究是一项随机对照3期优势性试验,在中国9个省17家医院开展,旨在进一步探究CME与D2切除术治疗右半结肠癌患者的疗效和

AJG:阿司匹林和选择性 5-羟色胺再摄取抑制剂的联合使用可以降低结直肠癌风险

结直肠癌 (CRC) 仍然是全世界第三大最常见的癌症,在2018年,结肠癌是全球癌症相关死亡的第二大原因,约占癌症病例和死亡人数的十分之一。