Risk Factors Of Intestinal Obstruction After Radical Gastrectomy

Objective: To investigate the risk factors of intestinal obstruction after radical gastrectomy,and to provide evidence for better prevention of intestinal obstruction after radical gastrectomy.Methods: The data of patients undergoing radical gastrectomy(including laparotomy and laparoscopy)in yijishan hospital affiliated to wannan medical college from December 2014 to December 2017 were retrospectively analyzed.Inclusion criteria for gastric cancer :(1)Postoperative pathological examination confirmed the diagnosis of gastric cancer;(2)Radical gastrectomy(including laparotomy and laparoscopic surgery)was performed in our hospital;(3)No distant metastasis was found during the operation.Exclusion criteria for gastric cancer :(1)Patients with gastric stump cancer;(2)Patients with recurrence after surgery in other hospitals;(3)Patients with Inflammatory bowel disease,Abdominal abscess and previous abdominal surgery.A total of 1051 patients with radical gastrectomy were counted,including 58 patients who were clearly diagnosed as intestinal obstruction after radical gastrectomy.According to two covariates of age and gender,the patients were paired according to 1:2,and 116 patients without intestinal obstruction after radical gastrectomy were selected from the gastric cancer operation cases from December 2014 to December 2017 as the control group.Retrospective paired study was conducted to analyze the risk factors of intestinal obstruction after radical gastrectomy.Results: Single factor analysis of postoperative intestinal obstruction in gastric cancer patients showed that,There was no statistically significant difference between the Intestinal obstruction group and the control group in the history of smoking,drinking,diabetes,hypertension,history of life style,hemoglobin at admission,and postoperative albumin at admission(P>0.05).Univariate analysis of the intraoperative and postoperative conditions of intestinal obstruction after radical gastrectomy showed that there were statistically significant differences between the intestinal obstruction group and the control group in the operative mode,tumor stage,operative time and combined visceral resection(P<0.05).There was no significant difference in intraoperative bleeding,intraoperative blood transfusion,postoperative hemoglobin,postoperative albumin and other postoperative complications between the ileus group and the control group(P>0.05).The influence factors with statistical significance in the univariate analysis results were analyzed further by Logistc regression analysis,and the results showed that the surgical mode,tumor staging and combined visceral resection were related to postoperative intestinal obstruction of gastric cancer(P<0.05),and the OR value of surgical mode was the highest.Conclusion: Patients with intestinal obstruction after radical gastrectomy are more likely to have open surgery,later tumor staging and combined visceral resection.