Clinical Analysis Of Postoperative Bleeding In Gastric Cancer

Objective:To investigate the risk factors of gastric cancer postoperative bleeding, summarize the experience in the diagnosis and treatment of postoperative bleeding through the16cases’clinical data, and improve the surgeons’understanding on postoperative bleeding.Methods:Retrospective analysis1689cases (978males and711females) of patients diagnosed with gastric cancer underwent operation in general surgery department of Shandong University Qi Lu Hospital from the time2008.1to2012.1, These patients’average age is56.23years old. We summarize the clinical features, preoperative illness data, surgery related factors and postoperative complications of patients respectively, and then analyze the bleeding risk factors and summarize the experience in the prevention and treatment of postoperative bleeding.Results:Among these1689gastric cancer patients underwent operation, There are16patients who occurred postoperative bleeding with the incidence0.95%(16/1689), which included10cases of gastrointestinal bleeding and6cases of abdominal bleeding.3patients bleed within24hours and the others13patients bleed after24hours.10patients were given conservative treatment, of which9were cured, one patient died of hemorrhagic shock due to bleeding and abdominal infection;6cases were re-operated to hemostasis,5patients were cured,1patient died of septic shock because of severe infection in lungs. Statistical analysis showed that peri-operative hypo-proteinemia, preoperative diabetes mellitus, postoperative intra-abdominal infection, operation time and surgical extent were important predisposing factors for bleeding; But the patients’gender, age, the way of digestive tract reconstruction and methods of anastomosis had little effect to the postoperative bleeding.Conclusion:Postoperative bleeding is one of the most severe complications in paitents underwent gastrectomy, the conservative treatment is used mostly, but if that doesn’t work, we shoud consider to stop bleeding by surgery. Improving preoperative preparation and the nutritional status of patients, active treatment of concomitant diseases; During radical gastrectomy which has a higher degree of trauma, operating carefully, the rational use of instruments, after operation stopping the bleeding carefully; rational use of antibiotics to prevent intra-abdominal infection all can effectively reduce the occurrence of postoperative bleeding of patients.