Exploration of the influencing factors on gastrointestinal function in patients undergoing laparoscopic radical resection of rectal cancer after surgery
10.3969/j.issn.1005-6483.20241237
- VernacularTitle:腹腔镜直肠癌根治术病人术后胃肠功能影响因素分析
- Author:
Xiang LI
1
;
Linqiu ZHOU
;
Jun LI
;
Jingjiang SHE
;
Jian XU
;
Jianchun DUAN
;
Yuwen LI
Author Information
1. 213000 江苏省常州市金坛第一人民医院胃肠外科
- Publication Type:Journal Article
- Keywords:
laparoscopic radical rectectomy;
postoperative gastrointestinal dysfunction;
Iinfluencing factors;
predictive model
- From:
Journal of Clinical Surgery
2025;33(7):730-734
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive factors for postoperative gastrointestinal function in patients undergoing laparoscopic radical rectectomy(LRR),and thereby construct a predictive model.Methods A total of 155 patients who underwent LRR at our hospital from February 2021 to April 2024 were selected for this study.Based on the postoperative intake-nausea-vomiting-examination-duration of symptoms(I-FEED)scoring system,patients were divided into postoperative gastrointestinal dysfunction(POGD)and non-POGD groups.Clinical data of the selected patients were collected,and Logistic regression analysis was used to identify factors influencing the occurrence of POGD in LRR patients.A predictive model for POGD was constructed,and its predictive performance was evaluated using the receiver operating characteristic(ROC)curve.The calibration ability of the model was assessed using the H-L test.Results Of the 155 LRR patients,2 were excluded due to intraoperative conversion to open surgery and 1 due to insufficient data,resulting in a total of 152 patients included in the analysis.The incidence of POGD in these 152 patients was 33.55％(51/152).Logistic regression analysis identified age(OR=2.687,95％CI=1.422-5.078,P=0.003),smoking history(OR=2.564,95％CI=1.395-4.713,P=0.004),preoperative albumin(Alb)level(OR=0.851,95％CI=0.781-0.927,P＜0.001),dexmedetomidine combined with general anesthesia(OR=0.382,95％CI=0.214-0.682,P=0.001),the location of the abdominal auxiliary incision(OR=2.992,95％CI=1.278-7.006,P=0.007)and ligation location of inferior mesenteric artery(OR=3.784,95％CI=1.624-8.815,P=0.001)as influencing factors for POGD in LRR patients.The ROC curve showed that the predictive model constructed using these factors had an area under the curve(AUC)of 0.905,indicating good predictive performance.The H-L goodness-of-fit test showed no significant difference between the predicted and observed values(P＞0.05),indicating good calibration ability.Conclusion Age,smoking history,preoperative Alb level,dexmedetomidine combined with general anesthesia,the location of the abdominal auxiliary incision and ligation location of inferior mesenteric artery are influencing factors for POGD in LRR patients.The predictive model constructed based on these factors has good predictive value and calibration ability,providing a basis for targeted prevention and treatment to reduce the risk of POGD.
