Zhang Ming-jie, Zhang Guo-lei, Yuan Wen-bin, Ni Jun, Gao Cai
Department of General Surgery, The Central Hospital of Huzhou City, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Feb;16(2):163-5.
To investigate the risk factors of postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy in gastric cancer and the impact of PGS on prognosis.
Clinical data of 422 patients who underwent subtotal gastrectomy for gastric cancer in the Central Hospital of Huzhou Sity from January 2004 to May 2010 were analyzed retrospectively. Risk factors of PGS were indentified and the recurrence-free survival was compared between the patients with and without PGS.
PGS occurred in 42 patients (9.5%). Univariate analysis showed that: age over 65, combination of anxiety disorder, low-albuminemia in perioperative period, pyloric obstruction in preoperative period, high serume glucose level (≥ 11.2 mmol/L) in postoperative period, Billroth II (gastroenterostomy, operation time over 4 hours, using patient-controlled analgesia, or intravenous fluid over 3500 ml/d (all P<0.05) were prone to develop PGS. These might be potential clinical risk factors associated to PGS. Correlation analysis showed the number of clinical risk factors was positively correlated with the incidence of PGS (r=0.967, P<0.05). A total of 215 cases (50.9%) were followed up for 3-60 months. The mean recurrence-free survival time of patients with PGS was 26.1 months, which was shorter than that of those without PGS (33.4 months, P=0.029).
Gastric cancer patients with the clinical risk factors mentioned above are prone to develop PGS after subtotal gastrectomy. PGS is associated with poor prognosis.
探讨胃癌胃大部切除术后胃瘫综合征（PGS）的危险因素及PGS对预后的影响。
回顾性分析2004年1月至2010年5月在湖州市中心医院行胃癌胃大部切除术的422例患者的临床资料。确定PGS的危险因素，并比较有PGS和无PGS患者的无复发生存率。
42例（9.5%）发生PGS。单因素分析显示：年龄>65岁、合并焦虑症、围手术期低白蛋白血症、术前幽门梗阻、术后血清葡萄糖水平高（≥11.2 mmol/L）、毕Ⅱ式（胃肠吻合术）、手术时间>4小时、使用患者自控镇痛或静脉输液量>3500 ml/d（均P<0.05）易发生PGS。这些可能是与PGS相关的潜在临床危险因素。相关性分析显示临床危险因素数量与PGS发生率呈正相关（r=0.967，P<0.05）。共215例（50.9%）随访3~60个月。PGS患者的平均无复发生存时间为26.1个月，短于无PGS患者（33.4个月，P=0.029）。
具有上述临床危险因素的胃癌患者胃大部切除术后易发生PGS。PGS与预后不良有关。
