| 62 | 0 | 3 |
| Downloads | Citas | Reads |
Objective To investigate risk factors for postoperative infection in patients undergoing radical gastrectomy for gastric cancer, providing evidence for optimizing perioperative prevention strategies. Methods A retrospective cohort study was conducted on 1 056 gastric cancer patients who underwent radical gastrectomy at a Grade A tertiary hospital in Gansu Province between 2021 and 2023. Patients were stratified into infection(n=105) and non-infection(n=951) groups. Potential risk factors were analyzed using univariate and multivariate logistic regression models. Results Multivariate analysis identified the following independent risk factors for postoperative infection: older age(OR=1.028, 95% CI: 1.001-1.056), body mass index(BMI)≥28(OR=2.319, 95%CI:1.044-5.152), diabetes mellitus(OR=2.293, 95%CI:1.047-5.023), tumor location(relative to cardia: gastric antrum OR=2.391,95% CI:1.152-4.962), intraoperative blood loss ≥100 m L(OR=1.874, 95% CI: 1.179-2.978), days of mechanical ventilator(OR=1.163, 95% CI:1.031-1.313), and days of central venous catheterization(OR=1.064, 95% CI:1.031-1.097). Laparoscopic surgery was a significant protective factor compared to open surgery(OR=0.107, 95% CI: 0.053-0.215). Distal gastrectomy(DG)was associated with a lower infection risk than total gastrectomy(TG)(OR=0.438, 95% CI: 0.254-0.754). Conclusions Postoperative infection risk is multifactorial, associated with patient comorbidities(age, obesity, diabetes), tumor location, surgical factors(approach, extent, blood loss), and invasive procedures. These findings underscore the need for enhanced perioperative management targeting modifiable risks to reduce postoperative infection risk.
[1]余炜燕,李雪,朱娟,等.中国及全球胃癌流行特征分析[J].中华肿瘤杂志,2025,47(6):468-476.
[2]马兴好,江晓阳,王传霞,等.预测胃癌D2根治术后感染风险列线图模型的建立与验证[J].中国感染控制杂志,2023,22(9):1013-1020.
[3]GBD 2017 Stomach Cancer Collaborators. The global, regional,and national burden of stomach cancer in 195 countries,1990-2017:A systematic analysis for the Global Burden of Disease study 2017[J].Lancet Gastroenterol Hepatol,2020,5(1):42-54.
[4]燕速,张书勤.胃癌术后手术部位感染的临床研究及思考[J].中华消化外科杂志,2022,21(12):1524-1531.
[5]Health Commission of The People's Republic of China N. National guidelines for diagnosis and treatment of gastric cancer2022 in China(English version)[J].Chin J Cancer Res,2022, 34(3):207-237.
[6]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):61-67.
[7]童禹浩,李军文,叶子翔,等.胃癌患者术后感染危险因素的Meta分析[J].基层医学论坛, 2021,25(4):1629-1633.
[8]RUIZ-Garc a E, GUADARRAMA-OROZCOJ, VIDAL-Mill n S,et al. Gastric cancer in Latin America[J].Scand J Gastroenterol,2018,53(2):124-129.
[9]黄于珊,蔡玲,张肖红,等.胃癌患者术后感染的危险因素[J].中国感染控制杂志,2019,18(6):582-586.
[10]李爱爱,仲伟明,吴亚亭,等.腹腔镜胃癌根治术后院内感染危险因素及风险预测模型构建[J].现代消化及介入诊疗,2022,27(10):1288-1292.
[11]巩玉亮,牛小康,郭勇.胃癌根治术术后手术部位感染的影响因素分析[J].癌症进展,2021,19(21):2218-2220.
[12]张小磊,江晓晖,江志伟,等.皮下持续负压引流对预防胃癌术后切口感染的效果[J].中国临床研究,2023,36(2):172-175,181.
[13]TSEKREKOS A, LOVECE A, CHRYSIKOS D, et al. Impact of obesity on the outcomes after gastrectomy for gastric cancer:A meta-analysis[J].Asian J Surg,2022,45(1):15-26.
[14]MAEJIMA K, TANIAI N, YOSHIDA H. The influences of obesity in laparoscopic and open distal gastrectomy for patients with early gastric cancer[J]. J Nippon Med Sch,2022,89(2):215-221.
[15]VOSBURG R, DRUAR NM, KIM JJ. Factors associated with increased risk for pulmonary embolism after metabolic and bariatric surgery:Analysis of nearly one million patients[J].Obes Surg,2022,32(7):2433-2437.
[16]HUANG YX, HE HY, CHEN K, et al. Prognostic impact and reasons for variability by tumor location in gastric cancer[J].World J Gastroenterol,2024,30(44):4709-4724.
[17]KONG L, YAN C, NIE S, et al. Comparison of proximal and distal gastric neuroendocrine carcinoma based on SEER database[J].Sci Rep,2024,14(1):25956.
[18]LIANG Y, WU L, LIU L, et al. Impact of extranodal tumor deposits on prognosis and N stage in gastric cancer[J].Surgery,2019,166(3):305-313.
[19]SO JB, RAO J, WONG AS, et al. Roux-en-Y or Billroth II reconstruction after radical distal gastrectomy for gastric cancer:A multicenter randomized controlled trial[J].Ann Surg,2018, 267(2):236-242.
[20]HIRAO M, FUJITANI K, TSUJINAKA T. Delayed gastric emptying after distal gastrectomy for gastric cancer[J].Hepatogastroenterology,2005,52(61):305-309.
[21]LI B, WONG IYH, CHAN FSY, et al. Comparison of laparoscopic versus open gastrectomy for gastric cancer[J]. Surg Oncol,2020(35):14-21.
[22]SEICEAN RI, PUSCASU D, GHEORGHIU A, et al. Anastomotic leakage after gastrectomy for gastric cancer[J].J Gastrointestin Liver Dis,2023,32(4):526-535.
[23]黄昌明,郑朝辉,林建贤.胃癌全胃切除术后食管空肠吻合口并发症防治中国专家共识(2020版)[J].中国实用外科杂志,2021,41(2):121-124.
[24]李昌立.全胃切除与近端胃切除治疗贲门癌的疗效对比[J].中外医疗,2012,31(11):93.
[25]代德柱,时谨,宋旭东,等.腹腔镜下全胃切除和近端胃切除治疗食管胃结合部腺癌的临床疗效对比[J].中国临床研究,2024,37(2):201-205.
[26]王晓民.全胃切除后Roux-en-Y吻合在近端胃癌患者中的应用及安全性分析[J].中国药物与临床,2020,20(13):2229-2231.
[27]FAN S, JIANG H, XU Q, et al. Risk factors for pneumonia after radical gastrectomy for gastric cancer:A systematic review and meta-analysis[J].BMC Cancer,2025,25(1):840.
[28]白丹,向雯,陈心足,等.胃癌术后肺部感染发生因素及围手术期干预措施[J].中华胃肠外科杂志,2021,24(2):185-190.
Basic Information:
DOI：10.13515/j.cnki.hnjpm.1006-8414.2026.04.008
China Classification Code:R735.2
Citation Information:
[1]WANG Jizhen,CHEN Yongcong,LIU Penghui ,et al.Retrospective analysis of risk factors for postoperative infection of 1 056 patients following radical gastrectomy in gastric cancer[J].Modern Disease Control and Prevention,2026,37(04):281-286.DOI:10.13515/j.cnki.hnjpm.1006-8414.2026.04.008.
Fund Information:
中国高校产学研创新基金资助课题（2024GR080）
2026-03-25
2026-03-25