Risk factors analysis and risk prediction model construction for delayed intestinal paralysis after complete laparoscopic right hemicolectomy combined with intraperitoneal thermal perfusion chemotherapy
10.11904/j.issn.1002-3070.2023.06.003
- VernacularTitle:完全腹腔镜右半结肠切除术联合腹腔热灌注化疗后延迟性肠麻痹危险因素分析与风险预测模型构建
- Author:
Boyan LIU
1
;
Yang YAN
;
Yuhui CHEN
;
Shidong HU
;
Yu YANG
;
Songyan LI
Author Information
1. 解放军总医院第一医学中心普通外科医学部(北京 100853)
- Keywords:
Right colon cancer;
Complete laparoscopic right hemicolectomy;
Delayed postoperative intestinal obstruction;
Risk factors;
Risk prediction model
- From:
Practical Oncology Journal
2023;37(6):472-477
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aim of this study was to investigate the risk factors for delayed postoperative ileus(PPOI)in colon cancer patients undergoing complete laparoscopic right hemicolectomy combined with intraperitoneal thermal perfusion chemotherapy(HIPEC),and establish a risk prediction model.Methods A retrospective analysis was performed on the case data of 68 colon canc-er patients who underwent complete laparoscopic right hemicolectomy combined with HIPEC at the Department of General Surgery,the First Medical Center of PLA General Hospital from January 2018 to January 2021.The incidence of PPOI was statistically analyzed,and its risk factors were analyzed.A nomogram of risk prediction model was constructed and the effectiveness was verified.Results Among the 83 patients,26 cases(31.3％)developed PPOI.Multivariate logistic regression analysis showed that diabetes(OR=14.820,95％CI:2.819-77.918),previous abdominal surgery(OR=6.514,95％CI:1.433-29.604),preoperative Hb＜9 g/L(OR=5.338,95％CI:1.197-23.809),intraoperative hemorrhage more than 200 mL(OR=4.869,95％CI:1.213-19.544),and not close the mesangial hiatal(OR=5.462,95％CI:1.408-21.186)were the risk factors for PPOI.Based on the results of multiva-riate analysis,a risk prediction model for ROC curve and PPOI nomogram was constructed.The internal validation consistency index(C-index)was 0.85(95％CI:0.735-0.957).Conclusion The risk factors for PPOI after complete laparoscopic right hemicolec-tomy combined with HIPEC are diabetes,previous abdominal surgery,preoperative Hb＜9 g/L,intraoperative hemorrhage more than 200 mL,and failure to close the mesangial hiatal.The constructed nomogram of risk prediction model for PPOI after complete laparo-scopic right hemicolectomy has a good evaluating effect and clinical application value.
