Risk factors relating to lymphatic leakage and prediction scoring model after radical gastrectomy for gastric carcinoma
10.3760/cma.j.cn113855-20200628-00514
- VernacularTitle:胃癌根治术后淋巴漏的危险因素分析及风险预测评分模型的建立
- Author:
Ping'an DING
1
;
Zhidong ZHANG
;
Peigang YANG
;
Yuan TIAN
;
Honghai GUO
;
Yang LIU
;
Tao ZHENG
;
Dong WANG
;
Yong LI
;
Qun ZHAO
Author Information
1. 河北医科大学第四医院外三科，石家庄050011
- Keywords:
Stomach neoplasms;
Risk factors;
Forecasting;
Lymphatic leakage
- From:
Chinese Journal of General Surgery
2021;36(7):530-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of lymphatic fistula after radical gastric cancer operation.Methods:We retrospectively analyze the clinicopathological data of gastric cancer patients who underwent radical surgery from May, 2019 to May, 2020 at the Third Department of Surgery, Fourth Hospital of Hebei Medical University, and analyze the risk factors impacting postoperative lymphatic leakage,for the establishment of the risk prediction scoring model.Results:A total of 487 patients with gastric cancer underwent radical gastrectomy, of which 32 patients (6.6%) had lymphatic leakage . Multivariate logistic regression analysis showed that hypoproteinemia before surgery (95% CI: 1.222-7.357, P=0.016), the lesion is located in the cardia-fundus of the stomach (95% CI: 1.117-6.788, P=0.028),stage T3-T4 (95% CI: 1.149-25.676, P=0.033), operation time ≥4 h (95% CI: 1.469-11.480, P=0.007), combined organ resection (95% CI: 1.106-12.886, P=0.034), D2+ lymph node dissection (95% CI: 1.969-11.510, P=0.001), anemia (95% CI: 1.271-9.392, P=0.015) were an independent risk factors. Equation based on multi-factor Logistic regression: logit( P)=-9.624+1.098×X 1+1.013×X 2+1.692×X 3+1.413×X 4+1.328×X 5+1.560×X 6+1.240×X 7 was estaslished, using Hosmer. Lemeshow test detects the goodness of fit of the regression equation ( P=0.348). The area under the ROC curve was 0.856 (95% CI: 0.787-0.926, P<0.001); the probability of lymphatic leakage when scores ≥4 points was 14.1%, when scores <4 points ,the probability of leakage was 2.5%. Conclusion:A risk prediction scoring model for lymphatic leakage after radical gastrectomy, can identify patients with high risk after surgery
