Preoperative risk modelling for oesophagectomy: A systematic review  

作　　者：James Paul Grantham Amanda Hii Jonathan Shenfine 

机构地区：[1]Department of General Surgery,Modbury Hospital,Adelaide 5092,South Australia,Australia [2]General Surgical Unit,Jersey General Hospital,Saint Helier JE13QS,Jersey,United Kingdom

出　　处：《World Journal of Gastrointestinal Surgery》2023年第3期450-470,共21页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Oesophageal cancer is a frequently observed and lethal malignancy worldwide.Surgical resection remains a realistic option for curative intent in the early stages of the disease.However,the decision to undertake oesophagectomy is significant as it exposes the patient to a substantial risk of morbidity and mortality.Therefore,appropriate patient selection,counselling and resource allocation is important.Many tools have been developed to aid surgeons in appropriate decision-making.AIM To examine all multivariate risk models that use preoperative and intraoperative information and establish which have the most clinical utility.METHODS A systematic review of the MEDLINE,EMBASE and Cochrane databases was conducted from 2000-2020.The search terms applied were((Oesophagectomy)AND(Risk OR predict OR model OR score)AND(Outcomes OR complications OR morbidity OR mortality OR length of stay OR anastomotic leak)).The applied inclusion criteria were articles assessing multivariate based tools using exclusively preoperatively available data to predict perioperative patient outcomes following oesophagectomy.The exclusion criteria were publications that described models requiring intra-operative or post-operative data and articles appraising only univariate predictors such as American Society of Anesthesiologists score,cardiopulmonary fitness or pre-operative sarcopenia.Articles that exclusively assessed distant outcomes such as long-term survival were excluded as were publications using cohorts mixed with other surgical procedures.The articles generated from each search were collated,processed and then reported in accordance with PRISMA guidelines.All risk models were appraised for clinical credibility,methodological quality,performance,validation,and clinical effectiveness.RESULTS The initial search of composite databases yielded 8715 articles which reduced to 5827 following the deduplication process.After title and abstract screening,197 potentially relevant texts were retrieved for detailed review.Twenty-seven publi

关 键 词：OESOPHAGECTOMY Risk model Oesophageal cancer PREOPERATIVE MORBIDITY MORTALITY 

分 类 号：R655.4[医药卫生—外科学]