School of Medicine, Nankai University, Tianjin, China.
Medical School of Chinese PLA, Beijing, China.
Sci Rep. 2024 Oct 12;14(1):23869. doi: 10.1038/s41598-024-74758-x.
This study aimed to analyze the complications and long-term survival outcomes in patients who underwent radical gastrectomy for gastric cancer, as well as to identify the risk factors associated with postoperative complications. After conducting a comprehensive search within the medical records system, a total of 2508 patients who underwent radical gastrectomy and met the inclusion criteria were enrolled. Of the 2508 patients, 301 were diagnosed with postoperative complications. The pathological data, postoperative recovery, and survival outcome were compared between complication and control group. Subsequently, univariate and multivariate logistic regression analyses were conducted to identified the risk factors. According to the Clavien-Dindo grading criteria for postoperative complications, the proportions of grade I, II, III, IV, and V complications following radical gastrectomy were observed to be 28.2%, 42.9%, 19.6%, 8.0%, and 1.3%, respectively. The presence of postoperative complications significantly prolonged the duration of gastrointestinal decompression (P < 0.001), catheter retention (P < 0.001), fasting (P < 0.001), and hospitalization (P < 0.001). Additionally, it had a detrimental impact on survival outcomes. Age > 65years [odds ratio (OR) = 1.378, P = 0.020], presence of diabetes (OR = 2.042, P < 0.001), operative duration > 215 min (OR = 1.450, P = 0.006), intraoperative blood loss > 275 ml (OR = 1.474, P = 0.004), and Roux-en-Y anastomosis for both whole stomach (OR = 1.567, P = 0.021) and distal gastric cancer (OR = 2.083, P = 0.003) were identified as independent risk factors for postoperative complications. This study analyzed the complications and survival outcomes following radical gastrectomy, and investigated the predictors for postoperative complications, thereby providing valuable guidance on the prevention and management of surgical complications in gastric cancer.
本研究旨在分析接受胃癌根治性胃切除术患者的并发症和长期生存结局,并确定与术后并发症相关的危险因素。通过在病历系统中进行全面检索,共纳入 2508 名符合纳入标准的接受根治性胃切除术的患者。在这 2508 名患者中,有 301 名患者诊断为术后并发症。对并发症组和对照组的病理资料、术后恢复和生存结局进行比较。随后,进行单因素和多因素 logistic 回归分析以确定危险因素。根据术后并发症的 Clavien-Dindo 分级标准,观察到根治性胃切除术后 I 级、II 级、III 级、IV 级和 V 级并发症的比例分别为 28.2%、42.9%、19.6%、8.0%和 1.3%。术后并发症的发生显著延长了胃肠减压(P < 0.001)、导管保留(P < 0.001)、禁食(P < 0.001)和住院时间(P < 0.001)。此外,它对生存结局产生了不利影响。年龄>65 岁[比值比(OR)=1.378,P=0.020]、合并糖尿病(OR=2.042,P<0.001)、手术时间>215 min(OR=1.450,P=0.006)、术中出血量>275 ml(OR=1.474,P=0.004)和全胃(OR=1.567,P=0.021)和远端胃癌(OR=2.083,P=0.003)的 Roux-en-Y 吻合术是术后并发症的独立危险因素。本研究分析了根治性胃切除术后的并发症和生存结局,并探讨了术后并发症的预测因素,为胃癌手术并发症的预防和管理提供了有价值的指导。