Analysis of risk factors for postsurgical gastroparesis syndrome (PGS) after operation for gastric cancer / 中华肿瘤杂志

ABSTRACT

Objective@#To investigate the risk factors for postsurgical gastroparesis syndrome (PGS) after surgery for stomach cancer.@*Methods@#A total of 684 patients with gastric cancer who underwent surgery for stomach cancer from Jan. 1, 2010 to Dec. 31, 2014 in Tai′an Tumor Prevention and Treatment Hospital, including 475 males and 209 females, with an average age of 59.9 years were identified and included in this study. There were 206 cases of gastric cardia and gastric fundus cancers and 478 cases of gastric antrum cancer. 206 cases underwent proximal radical subtotal gastrectomy and D2 lymph node dissection, 478 distal radical subtotal gastrectomy, 206 residual esophagogastric anastomosis, 311 Billroth-Ⅰ anastomosis, 99 Billroth-Ⅱ anastomosis, and 68 Billroth-Ⅱ plus Roux-en-y anastomosis. The incidence and risk factors of PGS were analyzed.@*Results@#All of the 684 patients were successfully operated.Among them, 48 (7.0%)encountered PGS. The univariate analysis showed that age, smoking index, alcohol consumption index, HP infection, scores of anxiety, preoperative albumin level, preoperative pyloric obstruction, site of resection, mode of anastomosis, whether to preserve the vagus nerve trunk, perioperative blood glucose level, abdominal cavity infection, and usage of postoperative analgesia pump were related to the occurrence of PGS (P<0.05 for all), while sex, hypertension, diabetes, perioperative hemoglobin level, perioperative electrolyte imbalance, operation duration, intraoperative blood loss, size of gastric remnant and number of dissected lymph nodes were not significantly related to the occurrence of PGS(P>0.05 for all). The multivariate binary logistic regression analysis showed that age, HP infection, scores of anxiety, perioperative albumin level, preoperative pyloric obstruction, site of resection, mode of anastomosis, whether to preserve the vagus nerve trunk, perioperative blood glucose level and abdominal cavity infection were risk factors for PGS (P<0.05 for all); while the age (<67 years old), perioperative albumin level (>35 g/L) and preservation of the vagus nerve trunk were protective factors of PGS (P<0.05 for all).@*Conclusions@#The occurrence of PGS is affected by many factors. Detailed evaluation of patients′symptoms and physical signs before operation and rectifying and eliminating risk factors are important to prevent and reduce the occurrence of PGS in patients with gastric cancer.