Clinical Study On The Influencing Factors Of Gastric Function Recovery After Radical Proximal Gastrictomy

Objective:Objective to retrospectively analyze the clinical data of patients with type II / III gastric esophagus adenocarcinoma(AEG)from 2013 to 2016 in Shanxi Province tumor hospital.Objective to study the effect of subtotal gastrectomy,total and partial resection of gastric pacing on the incidence of postoperative gastroparesis after radical gastrectomy for II / III gastric esophagus adenocarcinoma and to analyze the risk factors of postoperative gastroparesis.Methods:According to inclusion exclusion criteria selected 336 patients with gastric cancer treated with radical gastrectomy for gastric cardia cancer in Shanxi cancer hospital from2013 to 2016.According to the range of gastrectomy divided into three groups,the resection group(n = 113),partial resection group(n = 171)and the no resection group(n = 52).All patients were diagnosed with II / III gastric esophagus adenocarcinoma before operation,and underwent radical gastrectomy for gastric cancer.Complete resection group complete resection of gastric pacing.Partial resection group kept part of gastric pacing area.The gastric pacing area was not reserved in all resection group.The incidence of gastric dysfunction after operation in each group was calculated.To compare the incidence of gastroparesis in each group.According to the statistical results,25 patients with postoperative gastric dysfunction were divided into observation group and 311 patients with no postoperative gastric dysfunction were set as control group.The general data of the observation group and the control group were collected to analyze the risk factors of gastric dysfunction after radical gastrectomy for gastric cancer.Results:In the total resection group the incidence of gastric dysfunction was 12.4%(14/113).In the partial resection group the incidence of gastric dysfunction was 5.8%(10/171).In the no resection group the incidence of gastric dysfunction was 1.9 %(1/52).The incidence of gastric dysfunction in the no resection group was lower than that in the partial resection group.The incidence rate of gastric dysfunction in partial resection group was lower than that of total resection group.The difference was statistically significant(P<0.05).Single factor analysis of the factors affecting gastric dysfunction was related to age,BMI,perioperative albumin level,smoking index,alcohol consumption index,diabetes mellitus,perioperative blood glucose level,anxiety score,postoperative abdominal infection,surgical anastomosis,and whether the resection of gastric pacing area(P<0.05).Univariate analysis of gender,operative time,intraoperative blood loss,number of lymph node dissection,hypertension and perioperative hemoglobin levels were not associated with postoperative gastric dysfunction(P>0.05).Multivariate analysis showed that age,BMI,anxiety,postoperative abdominal infection,perioperative blood glucose level were independent risk factors for postoperative gastric dysfunction(P<0.05).Conclusion:Under the premise of radical cure in order to improve the recovery of gastric function in patients with gastric cancer after radical resection of gastric cardia cancer,it is necessary to preserve the gastric tissue of gastric pacing area as far as possible.Preserve the gastric tissue of gastric pacing area as far as possible can reduce the incidence of gastric dysfunction in patients.Patients with postoperative gastric dysfunction have a variety of risk factors,preoperative assessment of patients,preoperative preparation,postoperative management of patients as much as possible to avoid the risk factors,in order to reduce the occurrence of postoperative gastric dysfunction.