Meta-analysis Of Risk Factors In Postoperative Gastroparesis Syndrome After Gastroduodenal

ObjectiveWe evaluate the risk factors of incidence of postoperative gastroparesis syndrome after gastroduodenal and their associated main strength by Meta-analysis.Providing evidence-based basis to reduce the incidence of postoperative gastric paralysis syndrome.Methods19 articles were searched for risk factors of PGS published in China from June 2006 to June2016.We used Rev Man 5.1 software to test the heterogeneity of this articles.According the results of heterogeneity,We choose different models for Meta analysis.We assess the association of twelve risk factors and postoperative gastroparesis syndrome by the Odds ratio(OR)and 95%confidence intervals(95% CI).Results1.Gender: The Meta analysis included 15 studies about the association between gender and risk of PGS.The combined effect size OR was 0.95,95% CI(0.78,1.15),There was no obvious difference in PGS between male and female,P>0.05.2.Age: The Meta analysis included 15 studies about the association between age and risk of PGS.The combined effect size OR was 10.94,95% CI(9.43,12.45),there in a significant difference among various age group,P<0.05.3.Preoperative pyloric obstruction: The Meta analysis included 14 studies about the association between preoperative pyloric obstruction and risk of PGS.The combined effect size OR was 3.66,95% CI(2.95,4.54).The incidence of PGS of complicated with preoperative pyloric obstruction was higher than non-complicated with preoperative pyloric obstruction,P<0.05.4.Psycho-mental factors: The Meta analysis included 9 studies about the association between psycho-mental factors and risk of PGS.The combined effect size OR was2.93,95% CI(2.25,3.80).The incidence of PGS of unhealthy psychology was higher than healthy psychology,P<0.05.5.The kind of anastomosis: The Meta analysis included 16 studies about the association between the kind of anastomosis and risk of PGS.The combined effect size OR was 0.24,95%CI(0.19,0.30),P<0.05.The incidence of PGS of Billroth?reconstruction of gastrointestinal was lower than Billroth?reconstruction of gastrointestinal.The difference was statistically significant.6.Postoperative use of town postoperative pain pumps: The Meta analysis included 11 studies about the association between postoperative use of town postoperative pain pumps and risk of PGS.The combined effect size OR was2.47,95% CI(1.94,3.15).The incidence of PGS of postoperative use of town postoperative pain pumps was higher than postoperative nonuse of town postoperative pain pumps,P<0.05.7.Hypoalbuminemia surround operation period: The Meta analysis included 9 studies about association between hypoalbuminemia surround operation period and risk of PGS.The combined effect size OR was 2.61,95% CI(2.00,3.42).The incidence of PGS of hyperalbuminemia(?30g/L)surround operation period was lower than hypoalbuminemia(<30g/L),P<0.05.8.Surgery opportunity: The Meta analysis included 8 studies about the association between surgery opportunity and risk of PGS.The combined effect size OR was 1.86,95% CI(1.33,2.60).The incidence of PGS of selective operation was lower than emergency operation,P<0.05.9.Operation time: The Meta analysis included 5 studies about the association between operation time and risk of PGS.The combined effect size OR was 0.75,95% CI(0.65,0.84),there in a significant difference among various operation time,P<0.05.10.Amount of blood loss: The Meta analysis included 6 studies about the association between amount of blood loss and risk of PGS.The combined effect size OR was 84.39,95% CI(80.83,87.94),there in a significant difference among various amount of blood loss,P<0.05.11.Surgical option: The Meta analysis included 4 studies about the association between gender and risk of PGS.The combined effect size OR was 0.46,95% CI(0.30,0.73).The incidence of PGS of laparoscopic surgery was lower than laparotomy,P<0.05.12.Postoperative hyperglycemia :The Meta analysis included 5 studies about the association between gender and risk of PGS.The combined effect size OR was 4.13,95% CI(2.72,6.29).The incidence of PGS of postoperative non-hyperglycemia was lower than postoperative hyperglycemia,P<0.05.Conclusions In this study,the major risk factors o ostsurgical gastroparesis syndrom for Meta-analysis: Age,preoperative pyloric obstruction,postoperative hyperglycemia,operation time,surgery opportunity,surround operation period hypoalbuminemia,psychological factors,surgical option,postoperative use of town postoperative pain pumps,Billroth?reconstruction of gastrointestinal,amount of blood loss,postoperative use of town postoperative pain pumps.