Xu Rui, Gu Qiong, Xiao Shuomeng, Zhao Ping, Ding Zhi
Department of Gastrointestinal Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Front Oncol. 2022 Sep 14;12:951485. doi: 10.3389/fonc.2022.951485. eCollection 2022.
The study aims to assess the incidence of short-term patient-reported postoperative gastrointestinal symptoms (PGISs) after gastric cancer surgery and explore the relative risk factors for the symptoms.
Patients with radical gastrectomy were included for this retrospective and observational study. Symptoms extracted from the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI) were collected in postdischarge week (PDW) 1 and postoperative month (POM) 1. The distributing states of symptoms were analyzed in PDW1 and POM1. Logistic regression models were used to identify risk factors for PGISs.
Among 356 patients with complete interviews, 156 (43.8%) patients reported abdominal distention in PDW1, which was significantly higher than patients in POM1 [103 (28.9%), < 0.001]. Pain (15.2% vs. 9.8%), dysphagia (5.6% vs. 7.0%), diarrhea (3.7% vs. 3.4%), and vomiting (2.5% vs. 2.8%) had no significant differences between PDW1 and POM1. Logistic models found that risk factors for PGISs were total gastrectomy [odds ratio (OR): 1.948; 95% CI: 1.097-3.459; = 0.023] and disturbed sleep (OR: 3.116; 95% CI: 1.831-5.303; < 0.001) in PDW1 and female gender (OR: 1.726; 95% CI: 1.071-2.782; = 0.025), total gastrectomy (OR: 1.729; 95% CI: 1.055-2.834; = 0.030), and disturbed sleep (OR: 3.533; 95% CI: 1.757-7.106; < 0.001) in POM1.
The main symptom after gastric cancer surgery was abdominal distention. The relative risk factors for gastrointestinal symptoms after gastric cancer surgery were total gastrectomy and disturbed sleep. Timely symptom intervention may improve the quality of life of postgastrectomy patients.
本研究旨在评估胃癌手术后患者报告的短期术后胃肠道症状(PGISs)的发生率,并探讨这些症状的相关危险因素。
本回顾性观察研究纳入了接受根治性胃切除术的患者。在出院后第1周(PDW1)和术后第1个月(POM1)收集从MD安德森症状问卷胃肠道癌症模块(MDASI-GI)中提取的症状。分析了PDW1和POM1中症状的分布状态。使用逻辑回归模型确定PGISs的危险因素。
在356例接受完整访谈的患者中,156例(43.8%)患者在PDW1报告有腹胀,显著高于POM1中的患者[103例(28.9%),<0.001]。疼痛(15.2%对9.8%)、吞咽困难(5.6%对7.0%)、腹泻(3.7%对3.4%)和呕吐(2.5%对2.8%)在PDW1和POM1之间无显著差异。逻辑模型发现,PGISs的危险因素在PDW1为全胃切除术[比值比(OR):1.948;95%置信区间:1.097 - 3.459;P = 0.023]和睡眠障碍(OR:3.116;95%置信区间:1.831 - 5.303;P < 0.001),在POM1为女性(OR:1.726;95%置信区间:1.071 - 2.782;P = 0.025)、全胃切除术(OR:1.729;95%置信区间:1.055 - 2.834;P = 0.030)和睡眠障碍(OR:3.533;95%置信区间:1.757 - 7.106;P < 0.001)。
胃癌手术后的主要症状是腹胀。胃癌手术后胃肠道症状的相关危险因素是全胃切除术和睡眠障碍。及时的症状干预可能改善胃切除术后患者的生活质量。