腹腔镜远端胃癌根治术后胃排空延迟障碍的风险因素分析:历史性队列研究  

Risk factors analysis of delayed gastric emptying after laparoscopic distal gastrectomy for gastric cancer:a historical cohort study

作　　者：王尚 张琳 冯帆[1] WANG Shang;ZHANG Lin;FENG Fan(The Fourth Department of General Surgery,Jiaozuo People’s Hospital,Jiaozuo,Henan 454150,P.R.China)

机构地区：[1]焦作市人民医院普外四科,河南焦作454150

出　　处：《中国普外基础与临床杂志》2023年第11期1347-1352,共6页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的分析接受腹腔镜远端胃癌根治术患者术后胃排空延迟障碍(delayed gastric emptying,DGE的风险因素。方法回顾性收集2013年1月1日至2022年12月31日期间在焦作市人民医院接受腹腔镜远端胃癌根治术的胃癌患者,所有患者符合本研究的纳入和排除标准,采用多因素二元logistic回归分析探索影响DGE发生的风险因素。结果最终纳入了350例行腹腔镜远端胃癌根治术患者,其中有17例(4.9%)发生DGE。多因素二元logistic回归分析结果发现,术前胃流出道梗阻(OR=8.582,P=0.009)、术中留置空肠营养管(OR=14.317,P=0.010)、更多的腹腔引流管留置数目(OR=5.455,P=0.006)及术中出血量≥140 mL(OR=4.912,P=0.018)增加DGE发病风险。结论从本研究结果得出,对于接受腹腔镜远端胃癌根治术患者,存在术前胃流出道梗阻、术中安置了空肠营养管、腹腔引流管留置数目较多及术中出血量较大时,多注意DGE预防工作,力争早发现、早治疗,以改善患者的预后。Objective To analyze the risk factors affecting delayed gastric emptying(DGE)after laparoscopic distal gastrectomy for gastric cancer.Methods The gastric cancer patients who underwent laparoscopic distal gastrectomy in the Jiaozuo People’s Hospital from January 1,2013 to December 31,2022 were retrospectively collected.The occurrence of DGE was recorded.Meanwhile,the multivariate binary logistic regression analysis was performed to screen the risk factors affecting the DGE.Results A total of 350 gastric cancer patients underwent laparoscopic distal gastrectomy and met the inclusion and exclusion criteria of this study were included,17(4.9%)of whom developed DGE.The multivariate binary logistic regression analysis results showed that the preoperative gastric outflow tract obstruction(OR=8.582,P=0.009),intraoperative jejunal nutrition tube indwelling(OR=14.317,P=0.010),more peritoneal drainage tube placement(OR=5.455,P=0.006),and intraoperative blood loss≥140 mL(OR=4.912,P=0.018)increased the risk of DGE.Conclusion According to the results of this study,when patients undergoing laparoscopic distal radical gastrectomy for gastric cancer accompanied by preoperative gastric outflow tract obstruction,intraoperative jejunal nutrition tube indwelling,more peritoneal drainage tube placement,and more intraoperative blood loss,it should be paid more attention to prevention DGE,and early detection and treatment,so as to improve the prognosis of patients.

关 键 词：腹腔镜 远端胃癌根治术 胃排空延迟障碍 风险因素 

分 类 号：R735.2[医药卫生—肿瘤]