Analysis of risk factors for digestive tract leakage after radical gastrectomy / 国际外科学杂志

ABSTRACT

Objective To explore the relationship between gastrointestinal leakage after perioperative radical gastrectomy and perioperative factors.Methods The clinical data of 602 patients who underwent radical gastrectomy for gastric cancer in Beijing Friendship Hospital,Capital Medical University from January 2013 to December 2017 were retrospectively analyzed,including 420 male case and 182 female cases.Patients with postoperative gastrointestinal leakage of univariate and multivariate Logistic regression analysis.Results Of the 602 patients who underwent radical gastrectomy,44 (7.3％) had gastrointestinal leakage after operation,and the mean time was 9 (1 to 49) days.Univariate analysis showed that the incidence of digestive tract leakage after radical gastrectomy was age,body mass index (BMI) ≥ 24.0 kg/m2,previous drinking history,hypoproteinemia (＜40 g/L),carcino-embryonic antigen positive,CA19-9 positive,tumor site,combined organ The differences between resection,postoperative pathological type,postoperative T stage,postoperative N stage,postoperative M stage,and postoperative TNM staging were statistically significant (P ＜ 0.05).There was no significant difference between smoking,hypertension,diabetes,anemia and other factors (P ＞ 0.05).Multivariate logistic analysis showed that the history of combined drinking,BMI≥24.0 kg/m2,and the tumor site is based on the gastric body as the standard distal stomach,carcino-embryonic antigen,hypoproteinemia (＜ 40 g/L) were relatively independent risk factors for digestive tract leakage after radical gastrectomy.Conclusions Age,BMI ≥24.0 kg/m2,previous drinking history,hypoproteinemia (＜ 40 g/L),carcino-embryonic antigen positive,CA19-9 positive,tumor site,combined organ resection,postoperative pathological type,postoperative T stage,postoperative N stage,postoperative M stage,postoperative TNM staging and other factors are risk factors for digestive tract leakage after radical gastrectomy,while previous drinking history,hypoproteinemia (＜ 40 g/L),BMI (≥ 24.0 kg/m2),carcino-embryonic ontigen,tumor's site is a relatively independent risk factor for digestive tract leakage after radical gastrectomy.Serum albumin and BMI levels need to be strictly controlled during the perioperative period,and the occurrence of postoperative digestive tract leakage is reduced in the case of effective alcohol withdrawal.