Risk factors of Roux-en-Y stasis syndrome after total gastrectomy

doi:10.3877/cma.j.issn.1674-0793.2019.02.010

Abstract

Abstract:

Objective

To investigate the risk factors and preventive measures of Roux-en-Y stasis syndrome (RYS) after total gastrectomy.

Methods

Clinical data of seventy-six patients undergoing total gastrectomy in Yidu Central Hospital Affiliated to Weifang Medical University between July 2012 and July 2016 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate factors influencing RYS after total gastrectomy using log-rank and Logistic regression model.

Results

There were 45 males and 31 females with a median age of 59.5 years. The incidence of RYS after total gastrectomy was 10.53% (8/76). Univariate log-rank test indicated that antecolic reconstruction and the ascending limb measured more than 45 cm were significantly associated with RYS after total gastrectomy (χ²=7.578, 6.887; P=0.006, 0.009). Multivariate analysis showed that the ascending limb measured more than 45 cm was an independent factor of RYS after total gastrectomy (OR=11.625, 95%CI=1.286-105.052, P=0.029).

Conclusion

It is recommended that the ascending limb between esophagojejunostomy and enteroenterostomy should be about 40 cm in order to reduce the incidence of RYS.

Key words: Gastrectomy, Roux-en-Y stasis syndrome, Factor analysis, statistical

Qihua Yuan, Liying Chen, Jingwen Wang, Kaiming Leng. Risk factors of Roux-en-Y stasis syndrome after total gastrectomy[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(02): 134-136.

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Figures/Tables 3

References 9

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项目			发生	未发生	统计值	P值
例数			8	68	?	?
年龄(岁)			56(41~71)	60.5(39~78)	t=0.855	0.262
体质量指数(kg/m²)			24.8(23.4~28.7)	24.3(18.1~28.6)	t=0.140	0.768
手术时间(min)			297(185~351)	285(185~415)	t=0.372	0.651
失血量(ml)			175(80~800)	130(20~1 250)	t=1.505	0.857
性别(例)			?	?	χ²=0.032	0.857
?	男		5	40	?	?
?	女		3	28	?	?
肿瘤恶性程度(例)			?	?	-	0.287^a
?	良性		1	2	?	?
?	恶性		7	66	?	?
手术方式(例)			?	?	χ²=0.029	0.866
?	开腹		2	14	?	?
?	腹腔镜		6	54	?	?
吻合方式(例)			?	?	χ²=0.153	0.926
?	端-侧		4	33	?	?
?	端-端		1	6	?	?
?	侧-侧		3	29	?	?
吻合部位(例)			?	?	χ²=7.578	0.006
?	结肠前		7	21	?	?
?	结肠后		1	47	?	?
蠕动方向(例)			?	?	χ²=0.112	0.738
?	顺蠕动		5	51	?	?
?	逆蠕动		3	17	?	?
上升肠襻长度(例)		?		?	χ²=6.887	0.009
?	≥45 cm		6	16	?	?
?	<45 cm		2	52	?	?

项目			发生	未发生	统计值	P值
例数			8	68	?	?
年龄(岁)			56(41~71)	60.5(39~78)	t=0.855	0.262
体质量指数(kg/m²)			24.8(23.4~28.7)	24.3(18.1~28.6)	t=0.140	0.768
手术时间(min)			297(185~351)	285(185~415)	t=0.372	0.651
失血量(ml)			175(80~800)	130(20~1 250)	t=1.505	0.857
性别(例)			?	?	χ²=0.032	0.857
?	男		5	40	?	?
?	女		3	28	?	?
肿瘤恶性程度(例)			?	?	-	0.287^a
?	良性		1	2	?	?
?	恶性		7	66	?	?
手术方式(例)			?	?	χ²=0.029	0.866
?	开腹		2	14	?	?
?	腹腔镜		6	54	?	?
吻合方式(例)			?	?	χ²=0.153	0.926
?	端-侧		4	33	?	?
?	端-端		1	6	?	?
?	侧-侧		3	29	?	?
吻合部位(例)			?	?	χ²=7.578	0.006
?	结肠前		7	21	?	?
?	结肠后		1	47	?	?
蠕动方向(例)			?	?	χ²=0.112	0.738
?	顺蠕动		5	51	?	?
?	逆蠕动		3	17	?	?
上升肠襻长度(例)		?		?	χ²=6.887	0.009
?	≥45 cm		6	16	?	?
?	<45 cm		2	52	?	?

变量	Wald	95%CI	OR	P值
结肠前吻合口	0.073	0.087~24.930	1.476	0.787
上升肠襻长度≥45 cm	4.771	1.286~105.052	11.625	0.029

变量	Wald	95%CI	OR	P值
结肠前吻合口	0.073	0.087~24.930	1.476	0.787
上升肠襻长度≥45 cm	4.771	1.286~105.052	11.625	0.029

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