The Comparison And Analysis Of Risk Factors Of PGS After Laparoscope Assisted Radical Distal Gastrectomy And Laparotomy

Objective:The risk factors of postsurgical gastroparesis syndrome(PGS)were retrospectively analyzed on laparoscopic assisted and laparotomic most radical distal gastric resection,to provide preventive and therapeutic clues of PGS clinically.Methods:420 cases of radical distal gastrectomy caused by gastric cancer were retrospectively analyzed in Shanxi provincial people's hospital ranged from January 2008 to December 2017 in this paper.The patients were divided into two groups according to the operation methods,the laparoscopic auxiliary group(n= 202)and the open abdominal group(n=218).The occurrence and incidence of PGS were compared between the two groups statistically.Related literatures and preliminary experiment were carried on to determine the possible factors influencing postoperative PGS: gender,age,BMI,tumor size,smoking,diabetes history,whether preoperative pyloric obstruction occurred within three days,preoperative serum albumin level,operating time,the digestive tract reconstruction,postoperative hemoglobin levels within three days,postoperative abdominal cavity infection.The above information was analyzed by single factor analysis in the two groups respectively,and the significant factors were selected for further statistically study by Logistic regression analysis.Results:The incidences of PGS after laparoscopic and open surgery were 6.4% and 12.38%respectively,and there was statistically significant difference between the two groups(P<0.05).A single factor analysis was conducted for the risk factors of the two groups,and the relevant factors were selected to analyze the Logistic factors,and the independent risk factors of the two groups were obtained.It was found that the independent risk factors of PGS were preoperative pyloric obstruction,postoperative hemoglobin level and diabetes history.The independent risk factors affecting PGS were preoperative pyloric obstruction,operation time,postoperative hemoglobin level,postoperative abdominal infection,and diabetes history.Conclusion:The occurrence of PGS is influenced by many factors.Compared with the traditional open surgery,laparoscopic assisted most radical distal gastric resection patients had a lower risk of PGS.Perioperative period of laparoscopic assisted surgery should pay attention to improve pyloric obstruction situation,control blood glucose level.Apart from the above factors,correcting of anemia after operation,shortening the operation time as much as possible and preventing and controlling postoperative abdominal cavity infection might be helpful to reduce the incidence of PGS in open abdominal group.