|
|
|
| Influencing Factors of Intestinal Obstruction Following Chemotherapy after Laparoscopic Radical Surgery in Patients with Gastrointestinal Tumors |
| HUANG Yuanzhe, ZHANG Dingxi, ZOU Haoyang |
| Department of General Surgery, Xuchang People's Hospital, Xuchang Henan 461000 |
|
|
|
|
Abstract 【Objective】To investigate the factors influencing the occurrence of intestinal obstruction in patients with gastrointestinal tumors following laparoscopic radical surgery and subsequent chemotherapy.【Methods】A total of 162 patients who underwent laparoscopic radical surgery and postoperative chemotherapy for gastrointestinal tumors were followed for 30 days postoperatively. The incidence of intestinal obstruction was recorded. Univariate and multivariate Logistic regression analyses were performed to identify factors associated with the development of intestinal obstruction.【Results】Among the 162 patients, 13 cases developed intestinal obstruction within 30 days postoperatively, yielding an incidence rate of 8.02%. Factors showing significantly more prevalent in the obstruction group compared to the non-obstruction group included: male gender, age ≥70 years, tumor stage Ⅲ-Ⅳ, preoperative hypoproteinemia, history of preoperative intestinal obstruction, history of abdominal surgery, operative time ≥2 hours, combined organ resection, use of antiemetic drugs post-chemotherapy, time to first flatus ≥48 hours, time to first defecation ≥72 hours, time to recovery of bowel sounds ≥72 hours, and time to postoperative feeding ≥96 hours (P<0.05). Multivariate logistic regression analysis identified gender, age, tumor stage, preoperative hypoproteinemia, history of abdominal surgery, combined organ resection, use of antiemetic drugs post-chemotherapy, time to first flatus, time to first defecation, time to recovery of bowel sounds, and time to postoperative feeding as significant factors influencing the occurrence of intestinal obstruction (P<0.05).【Conclusion】The development of intestinal obstruction following chemotherapy after laparoscopic radical surgery in patients with gastrointestinal tumors is influenced by multiple factors, including gender, age, tumor stage, preoperative hypoproteinemia, history of abdominal surgery, combined organ resection, and use of antiemetic drugs post-chemotherapy. Clinicians should proactively implement preventive measures to minimize the risk of intestinal obstruction.
|
|
Received: 03 March 2025
|
|
|
|
|
|
[1] MANTESE G. Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment[J].Curr Opin Gastroenterol,2019,35(6):555-559.
[2] SCHAEFFER H D, GRIFFITHS R L, FACTOR M S. Neurofibromatosis-associated gastrointestinal stromal tumor causing small bowel obstruction[J].Am Surg,2022,88(7):1541-1542.
[3] BENTO J H, BIANCHI E T, TUSTUMI F, et al. Surgical management of malignant intestinal obstruction: outcome and prognostic factors[J].Chirurgia (Bucur),2019,114(3):343-351.
[4] 杨强,王绪霖.胃肠道疾病中西医实用手册[M].北京:人民军医出版社,2015:124-126.
[5] 中华医学会外科学分会腹腔镜与内镜外科学组,中国研究型医院学会机器人与腹腔镜外科专业委员会.腹腔镜胃癌手术操作指南(2016版)[J].中华消化外科杂志,2016,15(9):851.
[6] 中华医学会外科学分会腹腔镜与内镜外科学组,中华医学会外科学分会结直肠外科学组,中国医师协会外科医师分会结直肠外科医师委员会,等.腹腔镜结直肠癌根治术操作指南(2018版)[J].中华消化外科杂志,2018,17(9):877-885.
[7] 陈孝平,汪建平.外科学[M].8版.北京:人民卫生出版社,2013:373-379.
[8] 张凌志,刘争,李凯江.胃癌患者全腹腔镜全胃切除手术治疗的有效性及对患者并发症发生的影响[J].实用癌症杂志,2021,36(7):1167-1170.
[9] 尹彦斌,刘英兰,王跃生.结直肠癌术后肠梗阻的预防及治疗进展[J].中国医刊,2021,56(10):1057-1058.
[10] 卜宁,赵敏,赵莎,等.结直肠癌术后肠梗阻的危险因素分析及预测模型建立[J].临床麻醉学杂志,2021,37(7):677-683.
[11] 柳冉冉,于航娜,董蓓,等.腹腔镜治疗结直肠癌老年患者术后肠梗阻发生率及影响因素研究[J].实用癌症杂志,2021,36(1):112-115.
[12] 马磊,曹军,王欣,等.腹腔镜治疗结肠癌合并肠梗阻的临床效果及预后影响因素分析[J].中国现代普通外科进展,2022,25(2):143-147.
[13] 何秀萍,甘连州.急性阑尾炎腹腔镜切除手术后发生粘连性肠梗阻的影响因素[J].临床与病理杂志,2022,42(9):2134-2140.
[14] 姜宝,宫敏,郑涛,等.个体化预测腹腔镜胃癌术后小肠梗阻的列线图模型的建立[J].中国急救复苏与灾害医学杂志,2022,17(2):212-216.
[15] 乔永海,盖俊杰,姚芳,等.结肠癌切除术后粘连性肠梗阻发病率及危险因素分析[J].国际外科学杂志,2021,48(11):755. |
|
|
|
2025, Vol. 42 
