WEI Xingxing , WANG Panxing , ZHU Mengke , HAN Shangning , LIU Jiahuang , QIU Guanglin , LIAO Xinhua , FAN Lin , CHE Xiangming
  • Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University Medical College, Xi’an 710061, P. R. China;
CHE Xiangming, Email: chexiang@mail.xjtu.edu.cn
gastric cancer; hypoproteinemia; postoperative complication; risk factor
10.7507/1007-9424.202203047
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Objective  To investigate the risk factors of hypoproteinemia after laparoscopic assisted radical gastrectomy for gastric cancer and its influence on recent clinical outcome. Methods  Retrospective case-control study was carried out. Clinical data of 135 patients underwent laparoscopic assisted radical gastrectomy for gastric cancer admitted to the Department of General Surgery in the First Affiliated Hospital of Xi’an Jiaotong University Medical College from June 2016 to June 2021 were collected. Postoperative hypoproteinemia was defined as serum albumin <30 g/Lon postoperative day 1. Observation indications: ① the incidence of hypoproteinemia after laparoscopic assisted radical gastrectomy for gastric cancer; ② analysis of risk factors for postoperative hypoproteinemia; ③ influence of postoperative hypoproteinemia on recent clinical outcome. Results  ① Among 135 patients, 56 patients developed hypoproteinemia after operation (hypoproteinemia group) with an incidence of 41.5%, 79 patients without hypoproteinemia (non- hypoproteinemia group). ② Univariate analysis of risk factors for postoperative hypoproteinemia showed that age, preoperative albumin level, preoperative plasma volume, preoperative leukocyte, preoperative hemoglobin level, maximum tumor diameter, net intake on operative day and operative time were related to the occurrence of postoperative hypoproteinemia (P<0.05). The results of multivariate analysis showed that: age ≥65 years [OR=6.320, 95%CI (2.340, 17.068), P＜0.001], preoperative albumin level <35 g/L [OR=5.951, 95%CI (1.815, 19.507), P=0.003], operative time ≥5 h [OR=3.171, 95%CI (1.164, 8.640), P=0.024], and net intake on operative day ≥3 000 mL [OR=5.153, 95%CI (1.616, 16.432), P=0.006] were risk factors for postoperative hypoproteinemia. ③ Within 30 days after operation, the incidence of non surgery related complications in the hypoproteinemia group and the non-hypoproteinemia group were 30.4% (17/56) and 13.9% (11/79), respectively, and the incidence of surgery related complications were 10.7% (6/56) and 1.3% (1/79), respectively, with statistically significant differences (P<0.05). Conclusions  Age ≥65 years, preoperative albumin level <35 g/L, operative time ≥5 h and net intake on operative day ≥3 000 mL are risk factors for hypoproteinemia after laparoscopic assisted radical gastrectomy. For patients suffered from hypoproteinemia (albumin <30 g/L) after surgery, the incidences of both surgery-related complications and non-surgery-related complications increase.

Citation： WEI Xingxing, WANG Panxing, ZHU Mengke, HAN Shangning, LIU Jiahuang, QIU Guanglin, LIAO Xinhua, FAN Lin, CHE Xiangming. Multivariate analysis of hypoproteinemia after laparoscopic assisted radical gastrectomy forgastric cancer and its effect on recent clinical outcome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(11): 1482-1487. doi: 10.7507/1007-9424.202203047 Copy

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