| Objective Gastric cancer is one of the common digestive tract tumors,and its incidence rate is showing an upward trend in the world.The operation is complicated which of laparoscopic-assisted radical gastrectomy,there are many organs involved,and the surgical wound is large.At present,there is no consistent diagnosis and treatment guideline for the diagnosis and treatment of gastric cancer after surgery in the world.The purpose of this study was to explore the risk factors for postoperative complications of gastric cancer,and provide theoretical and clinical evidence for the prevention and treatment of postoperative complications of gastric cancer.Methods To collect and screen the clinical data of 485 patients who underwent assisted radical gastrectomy at Zhongshan Hospital of Xiamen University from January 2013 to January 2018,and use the Clavine-Dindo criteria to grade the postoperative complications..Chi-square test was used to retrospectively analyze the risk factors of each group of complications.Result Of the 485 patients,101 patients had recent postoperative complications.age(P=0.012),history of hypertension(P=0.028),surgical resection(P=0.034),and digestive tract reconstruction(P=0.040)were risk factors for postoperative bleeding;age(P=0.019),BMI(P=0.015),preoperative hypoproteinemia(P=0.005),surgical resection(P<0.001),digestive tract reconstruction(P=0.019),were risk factors for postoperative anastomotic leakage;age(P =0.026),preoperative hypoproteinemia(P=0.033),surgical resection(P=0.079),and digestive tract reconstruction(P=0.037)were risk factors for postoperative lymphatic spasm;diabetes(P=0.016),Previous history of abdominal surgery(P=0.023),surgical resection(P=0.001),and digestive tract remodeling(P=0.012)were risk factors for residual gastric dysmotility;surgical resection(P=0.032),digestive tract reconstruction(P=0.004)were risk factors for postoperative anastomotic stenosis;age(P=0.015),previous abdominal surgery(P=0.024),surgical resection(P=0.009),and digestive tract reconstruction(P= 0.045)were risk factors for postoperative ileus;BMI(P=0.010),preoperative glucosuria disease(P<0.001)and preoperative hypoproteinemia(P=0.002)were risk factors for postoperative incision site infection;gender(P=0.009)and age(P=0.013)were risk factors of postoperative lung infections.;age(P=0.001)was a risk factor for postoperative pleural effusion.Conlusion In this study,485 patients had a total of 20.82%of postoperative complications of grade II or higher in Clavine-Dindo classification.The incidence of postoperative bleeding was 4.12%,the incidence of anastomotic leakage was 3.92%,the incidence of pancreatic fistula was 0.62%.The incidence rate was 1.65%,the incidence of residual gastric dysmotility was 2.68%,the incidence of anastomotic stenosis was 3.09%,the incidence of postoperative intestinal obstruction was 3.29%,the incidence of surgical site infection was 3.71%,and the incidence of postoperative pulmonary infection was 9.89%.The incidence of posterior pleural effusion was 10.52%.In addition to the incidence of postoperative pancreatic fistulas and lymphatic fistulas reported in other literature,the incidence of other postoperative complications is almost the same as reported in most of the literature.For patients undergoing laparoscopic radical gastrectomy,preoperative examinations should be comprehensively improved to assess the general condition of the patient,treat the patient's underlying disease,and improve the patient's preoperative malnutrition,anemia,and other undesirable conditions;select the appropriate surgical method during surgery,in strict accordance with Standardized operation,team tacit understanding,fine operation;postoperative emphasis on recovery treatment,maintaining unobstructed drainage,strengthening nursing,early detection,early diagnosis of postoperative complications,and selection of reasonable treatment measures. |
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