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糖尿病对胃癌根治术后恢复的影响:一项回顾性队列研究。

Impact of diabetes on recovery after radical gastrectomy for gastric cancer: A retrospective cohort study.

作者信息

Zhao Lei, Wei Lan, Fei Xiao-Lu

机构信息

Department of Endocrine, Xuanwu Hospital Capital Medical University, Beijing 100053, China.

Information Center, Xuanwu Hospital Capital Medical University, Beijing 100053, China.

出版信息

World J Gastrointest Surg. 2025 Mar 27;17(3):100763. doi: 10.4240/wjgs.v17.i3.100763.

Abstract

BACKGROUND

Gastric cancer remains a significant global health concern. Radical gastrectomy is the primary curative treatment. Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer, including radical gastrectomy. Previous studies have suggested that diabetes can negatively affect postoperative outcomes, such as wound healing, infection rates, and overall recovery. However, the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood. evaluate the influence of diabetes on postoperative recovery, including hospital stay duration, complications, and readmission rates, in patients undergoing gastrectomy for gastric cancer. Understanding these effects could help optimize perioperative management and improve patient outcomes.

AIM

To investigate the impact of diabetes on recovery after radical gastrectomy for gastric cancer and associated postoperative outcomes.

METHODS

This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital, Capital Medical University, Beijing, China. We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020. The patients were divided into the diabetes and non-diabetes groups. The main outcomes included length of hospital stay, postoperative complications, and 30-day readmission rate. Secondary outcomes included quality of life indicators. Propensity score matching was used to adjust for potential confounding factors.

RESULTS

A total of 1210 patients were included in the study, with 302 diabetic patients and 908 non-diabetic patients. After propensity score matching, 280 patients were included in each group. Diabetic patients demonstrated significantly longer hospital stays (mean difference 2.3 days, 95%CI: 1.7-2.9, < 0.001) and higher rates of postoperative complications (OR 1.68, 95%CI: 1.32-2.14, < 0.001). The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group (12.5% 7.8%, = 0.02).

CONCLUSION

Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay, increased postoperative complications, and higher readmission rates, thus requiring optimized perioperative management strategies.

摘要

背景

胃癌仍然是全球重大的健康问题。根治性胃切除术是主要的治愈性治疗方法。糖尿病是接受胃癌手术(包括根治性胃切除术)患者的常见合并症。先前的研究表明,糖尿病会对术后结果产生负面影响,如伤口愈合、感染率和总体恢复情况。然而,糖尿病对胃癌根治性胃切除术后恢复的具体影响仍知之甚少。评估糖尿病对接受胃癌胃切除术患者术后恢复的影响,包括住院时间、并发症和再入院率。了解这些影响有助于优化围手术期管理并改善患者预后。

目的

探讨糖尿病对胃癌根治性胃切除术后恢复及相关术后结果的影响。

方法

这项回顾性队列研究在中国北京首都医科大学宣武医院内分泌科进行。我们检查了2010年1月至2020年12月期间接受胃癌根治性胃切除术的患者。患者分为糖尿病组和非糖尿病组。主要结局包括住院时间、术后并发症和30天再入院率。次要结局包括生活质量指标。采用倾向评分匹配法来调整潜在的混杂因素。

结果

本研究共纳入1210例患者,其中糖尿病患者302例,非糖尿病患者908例。倾向评分匹配后,每组纳入280例患者。糖尿病患者的住院时间明显更长(平均差异2.3天,95%置信区间:1.7 - 2.9,P < 0.001),术后并发症发生率更高(比值比1.68,95%置信区间:1.32 - 2.14,P < 0.001)。糖尿病组的30天再入院率也高于非糖尿病组(12.5%对7.8%,P = 0.02)。

结论

接受胃癌根治性胃切除术的糖尿病患者住院时间延长、术后并发症增加且再入院率更高,因此需要优化围手术期管理策略。

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