1.Risk factors for early postoperative infectious complications following laparoscopic gastrectomy:a single-center retrospective analysis of 1 572 cases
Xing'an WU ; Xinhua LIAO ; Guanglin QIU ; Haijiang WANG ; Mengke ZHU ; Jing LU ; Lin FAN ; Xiangming CHE
Chinese Journal of General Surgery 2025;34(4):745-752
Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3%)developed early postoperative infectious complications,including intra-abdominal infections(4.1%),surgical site infections(3.7%),and pulmonary infections(5.6%).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P<0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95%CI=4.194-12.935),smoking(OR=3.079,95%CI=2.261-4.913),and preoperative albumin<35 g/L(OR=0.572,95%CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.
2.Risk factors for early postoperative infectious complications following laparoscopic gastrectomy:a single-center retrospective analysis of 1 572 cases
Xing'an WU ; Xinhua LIAO ; Guanglin QIU ; Haijiang WANG ; Mengke ZHU ; Jing LU ; Lin FAN ; Xiangming CHE
Chinese Journal of General Surgery 2025;34(4):745-752
Background and Aims:Minimally invasive surgery,represented by laparoscopic techniques,plays a vital role in the treatment of gastric cancer.However,postoperative infectious complications remain a key factor affecting patient recovery and prognosis.This study was performed to identify the risk factors associated with early(≤1 month)infectious complications after laparoscopic surgery for gastric cancer,providing a reference for clinical prevention strategies.Methods:A retrospective analysis was conducted on 1 572 patients who underwent laparoscopic surgery for gastric cancer at the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to February 2024.Patients were divided into infection and non-infection groups based on the occurrence of postoperative infectious complications.Univariate and multivariate Logistic regression analyses were performed to identify related risk factors.Results:Among the 1 572 patients,194 cases(12.3%)developed early postoperative infectious complications,including intra-abdominal infections(4.1%),surgical site infections(3.7%),and pulmonary infections(5.6%).Univariate analysis revealed that a history of diabetes,pulmonary disease,smoking,and preoperative anemia and hypoalbuminemia were significantly associated with postoperative infections(all P<0.05).Multivariate analysis indicated that a history of diabetes(OR=6.927,95%CI=4.194-12.935),smoking(OR=3.079,95%CI=2.261-4.913),and preoperative albumin<35 g/L(OR=0.572,95%CI=0.302-1.578)were independent risk factors for early postoperative infectious complications.Conclusion:A history of diabetes,smoking,and preoperative hypoalbuminemia are closely associated with the occurrence of early postoperative infectious complications after laparoscopic gastric cancer surgery.Clinical attention should be paid to perioperative metabolic,nutritional,and lifestyle management,and early intervention for high-risk patients may help reduce the incidence of complications,improve recovery,and enhance treatment outcomes.
3.Effect of visceral fat area on the prognosis of patients with radical gastrectomy
Xiaowen LI ; Guanglin QIU ; Haijiang WANG ; Panxing WANG ; Jiahuang LIU ; Mengke ZHU ; Xinhua LIAO ; Lin FAN ; Xiangming CHE
Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(3):419-425
【Objective】 To investigate the predictive value of visceral fat area (VFA) in patients with gastric cancer after radical gastrectomy. 【Methods】 A retrospective analysis was performed on 195 patients who underwent radical gastrectomy in the Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University from January 2014 to December 2017. CT image data and clinicopathological data within 1 week before surgery were collected. VFA was calculated by software, and the patients were divided into VFA-H group (n=96) and VFA-L group (n=99). The relationship between VFA in different groups and long-term prognosis was compared. 【Results】 CT examination results showed that VFA value was (111±62) cm2, and BMI was positively correlated with VFA value (r=0.640, P<0.001). ROC curve showed that VFA was more valuable in predicting the prognosis of gastric cancer (AUC=0.703, P<0.001) and better than BMI. Cox regression analysis of prognostic factors in gastric cancer patients: Univariate analysis showed that age, tumor length, TNM stage and VFA were the influencing factors for prognosis, while multivariate analysis showed that TNM stage III and VFA-L were independent risk factors for prognosis of gastric cancer patients. 【Conclusion】 VFA has a good predictive ability and can be used to evaluate the prognosis of gastric cancer patients after operation.
4.Correlation between preoperative FPR and long-termprognosis in patients with gastric cancer
Panxing WANG ; Haijiang WANG ; Jiahuang LIU ; Mengke ZHU ; Xiaowen LI ; Xiangming CHE
Journal of Xi'an Jiaotong University(Medical Sciences) 2021;42(4):569-573
【Objective】 To confirm whether the preoperative fibrinogen to pre-albumin ratio (FPR) is a prognostic factor for patients with gastric adenocarcinoma and to analyze the relationship between FPR and clinicopathological characteristics of gastric adenocarcinoma patients. 【Methods】 We retrospectively reviewed the clinical data of 404 patients with gastric cancer who received radical gastrectomy in the Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, from January 2012 to December 2016. We analyzed the preoperative FPR’s effects on the prognosis of patients with gastric cancer and the relationship between FPR and the clinicopathological variables. 【Results】 The optimal cut-off point of FPR obtained by ROC curve analysis was 15.0, and gastric cancer patients were divided into low FPR group (<15.0) and high FPR group (≥15.0). The univariate Cox regression analysis showed that age, preoperative anemia, tumor size, histological grade, TNM stage, and preoperative FPR were risk factors for the prognosis of gastric cancer (P<0.05). The multivariate Cox regression analysis showed that TNM stage and preoperative FPR were independent prognostic factors for gastric cancer (P<0.05). The subgroup analysis results indicated that the prognosis of patients in the low FPR group was better than that in the high FPR group of patients with stage Ⅰ-Ⅱ and stage Ⅲ gastric cancer (P<0.05). Further analysis showed that compared with those in the high FPR group, patients in the low FPR group had an older age, a larger proportion of males, a lower rate of anemia before surgery, smaller tumor diameter, and earlier TNM staging (P<0.05). 【Conclusion】 The preoperative FPR is an independent prognostic factor for gastric cancer. This study provides a clinical basis for its application in predicting the long-term prognosis of patients with gastric cancer.
5.Correlations of prognosis, outcomes with myocardial dysfunction of aneurysmal subarachnoid hemorrhage
Lei FENG ; Tao LIN ; Haijiang CHE ; Peng WANG
Journal of Chinese Physician 2016;18(7):1013-1016
Objective To investigate the correlation between aneurysmal subarachnoid hDepartment of Neurosurgery,Xi Dian Group Hospital,Xi'an 710077,Chinaemorrhage (aSAH) and myocardial dysfunction (MD).Methods Totally 96 cases of aSAH patients meeting the criterion were chosen,and the correlations of electrocardiograph (ECG),and ultrasonic cardiogram (UCG)with delayed cerebral ischemia (DCI),death and poor outcome and death were analyzed.Results Of the 93 cases of aSAH patients meeting the criterion,DCI rate was 59.2%,death rate was 19.4%,and poor outcome rate was 21.5%.With multivariable Poisson regression analysis,the results showed that wall motion score index (WMSI) > 1.1 was correlated with death and poor outcome,mid-ventricular wall motion abnormality (WMAs) was correlated with death,and apical WMAs was correlated with DCI.Conclusions Myocardial dysfunction is significantly related to outcome of aSAH.Thus,this study may provide a reference for prognosis assessment and treatment of aSAH.

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