Objective To analyze the risk factors for postoperative gastroparesis syndrome(PGS)in gastric cancer patients undergoing laparoscopic radical gastrectomy(LRG)and to construct and validate a nomogram prediction model for PGS.Methods The clinical data of 439 gastric cancer patients were retrospectively analyzed.Patients were divided into PGS group and control group based on whether PGS occurred within 2 months after surgery.Logistic regression analysis was used to screen for risk factors of PGS in LRG patients,and a nomogram prediction model was constructed based on the screening results.The discriminative ability of the nomogram was assessed by the receiv-er operating characteristic(ROC)curve,and its consistency was evaluated by the calibration curve.Results Among 439 patients,52 developed PGS,with an incidence rate of 11.85％.The propor-tions of patients aged ≥60 years,complicating with diabetes,having a history of abdominal surgery,complicating with pyloric obstruction,having surgery duration≥4 hours,and intraoperative anasto-mosis type of B-Ⅱ were higher in the PGS group than those in the control group(P＜0.05).The results of multivariate Logistic regression analysis showed that diabetes,a history of abdominal surger-y,pyloric obstruction,surgery duration ≥4 hours,and intraoperative anastomosis type of B-Ⅱ were risk factors for PGS in LRG patients(P＜0.05).Internal validation results showed that the area un-der the ROC curve was 0.839(95％CI,0.773 to 0.905),the calibration curve fitted well,and the Hosmer-Lemeshow goodness-of-fit test result was good(x2=9.078,P=0.247).Conclusion Diabetes,a history of abdominal surgery,pyloric obstruction,surgery duration ≥4 hours,and intraoperative anastomosis type of B-Ⅱ are risk factors for PGS in LRG patients.The nomogram constructed based on these factors can effectively predict the risk of PGS in LRG patients.
关键词
腹腔镜/胃癌根治术/术后胃瘫综合征/危险因素/列线图
Key words
laparoscopy/radical gastrectomy for gastric cancer/postoperative gastroparesis syndrome/risk factors/nomogram
维普
万方数据