Clinical Analysis Of High Risk Factors Of Gastroparesis Syndrome After Radical Distal Subtotal Gastrectomy

Objective: Review of the research on radical surgery of Wangnan Medical College affiliated Yijishan hospital from 2014 to 2016 a total of 229 patients with distal gastric cancer cases,aims to analyze the risk factors of postoperative gastroparesis syndrome,and provide reference for clinical prevention and treatment,reduce the incidence of postoperative gastroparesis syndrome.Methods: We collect data of 229 patients from Wangnan Medical College affiliated Yijishan hospital’s gastrointestinal Department of surger.They were taken radical distal gastrectomy between June 2014 and June 2016.There are 19 patients get gastric postsurgical gastroparesis syndrome,including male 13 patients,female 6 patients,male: female =13:6;age from 39 to 79 years old,the average age is 61.68 years old.The patients were divided into gastroparesis group and non gastroparesis group,select general,preoperative,intraoperative and postoperative total of 19 risk factors take single factor χ2 test,multivariate Logistic regression analysis was used to analyze the significant differences in perioperative period.Results: The total number of cases in this study was 229 cases,the incidence of PGS is 8.29%(19/229).Through the single factor χ2 test results we can know that: obesity,preoperative malnutrition,preoperative pyloric obstruction,perioperative low protein(serum albumin < 30g/l),perioperative hyperglycemia(glucose > 8mmol/l),gastrointestinal anastomosis(Billroth I type and Billroth II type),abdominal complications after operation,anxiety,these eight factors related to PGS(P < 0.05);and the patients’ gender and age,history of hypertension,anemia before operation,preoperative neoadjuvant chemotherapy,intraoperative intraperitoneal infusion therapy,surgery(laparoscopic or the traditional open surgery),operation time(whether > 3.5h),operative blood loss(whether > 400ml),postoperative pathological staging,using postoperative analgesia pump had no statistical significance(P > 0.05),multivariate Logistic regression analysis showed that preoperative obstruction,perioperative low protein(serum albumin < 30g/l),perioperative hyperglycemia(glucose > 8mmol/l),anxiety were the risk factors of PGS(OR < 1,P < 0.05),and Billroth I anastomosis is a protective factor for PGS(OR < 1,P < 0.05).Conclusion: PGS is caused by many factors,the single factor χ2 test showed that obesity,preoperative malnutrition,preoperative pyloric obstruction,perioperative low protein(serum albumin < 30g/l),perioperative hyperglycemia(glucose > 8mmol/l),gastrointestinal anastomosis(Billroth I type and Billroth II type),abdominal complications after operation,anxiety are related to PGS.multivariate Logistic regression analysis showed that preoperative obstruction,perioperative low protein,perioperative hyperglycemia,anxiety were the risk factors of PGS,and Billroth I anastomosis is a protective factor for PGS.In clinical work,medical workers should take into account the related risk factors of PGS,work actively to do a good job of risk factors,so as to effectively avoid postoperative gastroparesis syndrome,improve the effect of surgery,reduce postoperative unnecessary pain,provide more effective protection for the prevention and treatment of PGS.