Relationship between endobiochemical environment and postoperative complications after laparo-scopic sleeve gastrectomy and Roux-en-Y gastric bypass
Objective To investigate the relationship between the endobiochemical environment and postoperative complications after laparoscopic sleeve gastrectomy(LSG)and Roux-en-Y gastric bypass(LRYGB).Methods A total of 200 patients received LSG and LRYGB from the First Hospital of Hebei Medical University from January 2020 to December 2022,including 141 patients receiving LSG and 59 pa-tients receiving LRYGB.The patients were followed up for half a year and divided into complication group and non-complication group according to whether complications occurred within 30 days after operation.T test and x2 test were used to compare clinical data and endobiochemical indexes of the two groups,and the risk factors of postoperative complications were analyzed by binary Logistic regression,and the prediction model was constructed.The predictive efficiency of the model was analyzed by receiver operating character-istic(ROC)curve.Hosmer-Lemeshow test was used to evaluate the goodness of fit of the model.Results The incidence of hypertension[34.62％(9/26)vs.17.24％(30/174)]and visceral obesity[96.15％(25/26)vs.75.86％(132/174)]in the complication group was higher than that in the non-complication group(x2=4.350,5.519,P＜0.05).CD3+[(43.23±5.75)％vs.(51.53±6.04)％]andCD4+/CD8+(1.19±0.25 vs.1.42±0.27)in the complication group were lower than those in the non-complication group(t=-6.575,55.864,P＜0.05).Blood lactic acid[(0.73±0.33)vs.(0.59±0.21)mmol/L]in the complication group was higher than that in the non-complication group(t=2.920,P＜0.05).Logis-tic regression analysis showed that high CD3+and CD4+/CD8+rate was the protective factor for postopera-tive complications[odds ratio(OR)=0.602,95％confidence interval(CI):0.452-0.803,P＜0.05;OR=0.002,95％CI:0.000-0.145,P＜0.05],and high blood lactic acid was the risk factor(OR=1 831 920.488,95％CI:1 875.614-1 789 245 268.000,P＜0.01).Hosmer-Lemeshow test showed that x2=2.381,P＞0.05,and the model had good goodness of fit.ROC analysis showed that the area under curve(AUC)of the evaluation model was 0.664.Conclusion In this paper,the model constructed by the postoperative endobiochemical environment has high predictive value for postoperative complications.
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