Relationship Between Gastric Parelysis And Gastrointestinal Reconstruction Of Radical Distal Gastrectomy For Gastric Cancer

Purpose:Postsurgical gastroparesis syndrome(PGS)is a common postoperative complication secondary to abdominal surgery,and this study explores the relationship between different digestive tract reconstruction methods and the incidence of PGS after radical gastric resection by conducting a clinical retrospective study on the possible risk factors for gastric paralysis syndrome after radical gastrectomy for distal gastric cancer,in order to reduce the incidence of PGS clinically.Method:From 2017 to 2021,687 patients with gastric cancer who underwent radical gastric cancer distal gastric cancer resection in the gastrointestinal surgery ward of a hospital were collected,and all patients were clearly diagnosed as gastric cancer after surgery,including48 patients with gastric paralysis symptoms and 639 patients without gastric paralysis symptoms.Factors that may influence symptoms of gastric palsy during the perioperative period were analyzed,including sex,age,BMI,pathologic stage,preoperative pyloric obstruction,preoperative hemoglobin count,preoperative albumin count,surgical modality,gastrointestinal reconstruction,and postoperative use of analgesic pumps.SPSS25.0 was used for statistical analysis,and χ2 was used for the test method,and P<0.05 was statistically significant.The influencing factors of P<0.05 were regressed to explore the relationship between gastrointestinal reconstruction and PGS.Result:PGS developed in 48 of the 687 patients included in the study,with an incidence of 7.0%(48/687).After the χ2 test of single factors,the results showed whether there was pyloric obstruction before surgery,whether analgesic pumps were used after surgery,and the surgical method and gastrointestinal reconstruction method were statistically significant with the occurrence of PGS.There were no significant signs in age,sex,BMI,pathological stage,preoperative hemoglobin count,preoperative albumin count and PGS.The factors of P<0.05 were further included in the regression analysis,and the results showed that preoperative pyloric obstruction and postoperative use of analgesic pumps were independent risk factors for the occurrence of gastric paralysis,and laparoscopic assisted surgery and gastrointestinal reconstruction were protective factors.Compared with Billroth II anastomosis,the incidence of Billroth I anastomosis PGS decreased by about 73%,the incidence of Billroth II + Braun PGS decreased by about55%,and the incidence of Roux-en-Y anastomosed PGS decreased by about 78%.Conclusion:1.The digestive tract reconstruction method of radical gastrectomy is closely related to postoperative gastric paralysis,and the reconstruction method is a protective factor for postoperative gastric paralysis.2.In terms of postoperative gastric paralysis,Billroth I anastomosis,Billroth II + Braun anastomosis,and Roux-en-Y anastomosis after surgery for distal gastric cancer are less likely to occur than Billroth II anastomosis alone.