Causes And Prevention For Postoperative Gastroparesis Syndrome Of Resection Of Gastric Carcinoma

Objective:To investigate the possible clinical factors、diagnosis、 treatment and prevention contributing to PGS after distal gastrectomy for gastric cancer.Methods:Through the retrospectively analysis of548patients who had the distal gastrectomy for gastric cancer in Qilu Hospital of Shandong University from2007to2010, there were37cases of PGS. Among them,25cases were male patients, and12cases were female patients (the M:F2.08:1); their ages range from27to80years old, average age was61.68years old. Using the retrospective analysis method, statistical analysis patients’sex, age, anemia, pyloric obstruction, digestive tract reconstruction, the operation duration time, analgesia pump during operation period, hypoalbuminemia and surround operation period high blood sugar, according to the above factors they were divided into PGS group and non PGS group, the statistics of line of x2test, P<0.05for significant difference standard.Results:The incidence rate of the37cases of PGS is6.67%(37/548); After the conservative treatment of mainly through enteral nutrition support,26cases’(70%) gastrointestinal motility were recovery within4weeks after operation,36cases’(97%) gastrointestinal motility were recovery within6weeks after operation,1cases (2.7%) as a second operation line of gastrostomy interposition of jejunum nutrition tube after the2weeks’conservative treatment recovered after7weeks. The statistical analysis showed that anemia, pyloric obstruction, digestive tract reconstruction, operation duration, applying analgesic pump, surround operation period high blood sugar and other factors were the risk factors on PGS; and the patient’s sex, age had little impact on PGS.Conclusion:Through the improvement of preoperative preparation, improving the nutritional status of patients, active treatment of complicated disease; intraoperative careful operation, the rational use of stapler, closure devices equipments etc., shortening operation time, can effectively prevent PGS for a higher degree、larger trauma operation. Using conservative treatment of enteral nutrition support and prokinetic drug after PGS, is a reliable treatment method for PGS, should be evaluated cautiously, avoid operation.