Clinical Investigation Of Gastrointestinal Leakage After Gastric Cancer Operation In Patients With 81 Cases

Objective : To summarize the influencing factors and preventive measures of Gastrointestinal leakage after gastric cancer, we collected 5702 cases who were diagnosed with gastric cancers operation and underwent operations within 11 years.Methods:5702 individuals, who were admitted to the Fourth of Hebei Medical University for treatment of gastric cancer and received operations from January 1996 to December 2006 were recruited for this study, and the patients who had undergone the laparotomy, thoracotomy or short-circuit operations were excluded. The diagnostic criteria for Gastrointestinal leakage includes clinical manifestations of postoperative fever, signs of peritonitis, turbid draining liquid, and confirmed imaging tests. Data base of the 5,702 individuals was set up, and 81 of them with the compication of Gastrointestinal leakage were specially analyzed. These statistical analyses were performed with a computer software program for Microsoft Windows(SPSS,18.0),and statistical significance was set at P<0.05.Results:The incidence rate of Gastrointestinal leakage was 1.44% in the gastric cancer group, 6.04% in the gastric cancer-with-diabetes group, and 1.30% in the control group. The difference between the different groups was considered to be significant(χ~2=23.32,P=0.00002). The incidence rate of Gastrointestinal leakage was 2.11% in the gastric cancer-with-anemia group,while 1.17% in the control group. The difference between these two groups was considered to be significant (χ~2=6.94,P=0.008). The incidence rate of Gastrointestinal leakage was 4.13% in the gastric cancer-with-hypoproteinemia group,while 1.31% in the control group. The difference between these two groups was also considered to be significant(χ~2=11.87 , P=0.0006).Among all the cases,18 cases with multivisceral excisions finally presented Gastrointestinal leakage(5.31%).It was reported that the high incidence rate of Gastrointestinal leakage was possibly caused by the large tumors which had invaded peripheral organs. Imaging tests are the main methods to examine the leakage.Conclusion: Gastrointestinal leakage is one of the serious complications after gastric cancer which is commonly seen in the field of gastric surgery. It has been clarified that the incidence of Gastrointestinal leakage is correlated with many pre-existing complications like anemia, hypoproteinemia, diabetes ,and so on. Therefore, it is necessary to improve patients'conditions before carrying out operations to reduce the risk of getting Gastrointestinal leakage. In addition, suitable and timely therapeutic measures can decrease the incidence of Gastrointestinal leakage and thus promote the healing of it.