The occurrence of complications following radical gastrectomy for gastric cancer significantly impacts patients’ quality of life. Elderly patients are susceptible to postoperative complications. This study seeks to investigate the risk factors associated with Clavien-Dindo ≥IIgrade complications following radical gastrectomy for advanced gastric cancer in elderly patients, develop a nomogram risk prediction model, and validate its accuracy. Retrospective collection of clinical and pathological data was conducted on 442 elderly patients with advanced gastric cancer who underwent radical gastrectomy at Shaanxi Provincial People’s Hospital from January 2015 to December 2020. They were randomly divided into a training set (n = 310) and a validation set (n = 132) in a 7:3 ratio. The severity of postoperative complications was graded using the Clavien-Dindo classification system, resulting in two complication groups: Clavien-Dindo

AIM:Small bowel obstruction is a common condition that requires emergency surgery. Slow recovery of bowel function after surgery or the occurrence of one or more complications can exacerbate the disease and result in severe small bowel obstruction (SSBO), significantly impacting recovery. It is characterized by a failure to regain enteral nutrition promptly, requiring long-term intensive care. Therefore, it is necessary to identify factors that predict SSBO, to allow early intervention for patients likely to develop this condition.METHODS:Of the 260 patients who underwent emergency or elective surgery for small bowel obstruction between January 2018 and December 2022, 45 developed SSBO. The least absolute shrinkage and selection operator regression model was applied to optimize factor selection and multivariable logistic regression analysis was used to construct a predictive model. The performance and clinical utility of the nomogram were determined and internal validation was conducted. In addition, the effects of the Houpu Paiqi mixture on postoperative recovery were analyzed by comparing the clinical data of 28 patients who were treated with the mixture and 61patients who did not receive it.RESULTS:The predictors included in the prediction nomogram were age, peritonitis, intestinal resection and anastomosis, complications, operation time, Acute Physiology and Chronic Health Evaluation II score, white blood cell count, and procalcitonin level. The model had an area under the receiver operating characteristic curve of 0.948 (95% confidence interval: 0.814-0.956). Decision curve analysis demonstrated that the SSBO risk nomogram had a good net clinical benefit. In addition, treatment with the Houpu Paiqi mixture reduced postoperative exhaust time, postoperative defecation time, time to first postoperative liquid feed, and length of stay in hospital.CONCLUSIONS:We developed a nomogram that can assist clinicians in identifying patients at greater risk of SSBO, which may aid in early diagnosis and intervention. Additionally, we found that the Houpu Paiqi mixture promoted postoperative recovery.

Objective:To explore the occurrence and related risk factors of perioperative complications after radical gastrectomy in elderly patients with gastric cancer.Methods:The clinical and pathological data of 168 elderly patients with gastric cancer who underwent radical total resection in Shaanxi Provincial People’s Hospital from January 2015 to January 2020 were retrospectively collected. According to whether the perioperative complications occurred, the patients were divided into complication group and non-complication group. Postoperative complications were graded using Clavien-Dindo complication grading system, and the risk factors were determined by single factor and multiple factor logistic regression model. The predictive effect of the model was evaluated by the area under receiver operating characteristics (ROC) curve.Results:Postoperative complications occurred in 38 cases (22.62%), mainly pulmonary infection, anastomosis-related complications and incision-related complications, with 13 cases (34.21%) of Clavien-Dindo≥Ⅲ. Body mass index≥25 kg/m2, GNRI<92, complicated underlying diseases, upper gastric tumors, and TNM stage Ⅲ were independent risk factors for perioperative complications after radical gastrectomy in the elderly (P<0.05). The area under ROC curve value of its prediction model was 0.719 (95% CI: 0.623-0.815), and the prediction effect was good.Conclusions:There are many factors that affect the occurrence of complications during the perioperative period of radical total gastrectomy in elderly patients. In order to reduce the risk of complications and improve the prognosis, targeted intervention measures should be taken according to relevant risk factors.

目的 探讨腹壁切口疝修补术后慢性疼痛的发生状况及相关因素,以期降低术后慢性疼痛的发生率,提高患者生活质量.方法 选取2015年1月至2019年12月陕西省人民医院收治的213例腹壁切口疝患者作为研究对象.随访观察患者行腹壁切口疝修补术后1年内发生慢性疼痛的情况,将其分为发生疼痛组和未发生疼痛组,筛选出术后慢性疼痛的危险因素.结果 共有27例患者发生慢性疼痛,发生率为12.68％.单因素分析结果显示,两组性别、体质指数(BMI)、复发疝、术后切口并发症比较,差异均有统计学意义(P<0.05).进一步行多因素Logistic回归分析显示,女性(β=1.82,OR=6.17,95％CI:1.34～28.46,P=0.020)、BMI≥24 kg/m2(β=1.04,OR=2.82,95％CI:1.09～7.32,P=0.034)、复发疝(β=1.73,OR=5.65,95％CI:1.88～17.02,P=0.002)、术后切口并发症(β=1.43,OR=4.16,95％CI:1.53～11.33,P=0.005)是术后发生慢性疼痛的独立危险因素.结论 女性、BMI≥24 kg/m2、复发疝、术后切口并发症是腹壁切口疝患者术后发生慢性疼痛的独立危险因素,因此在行切口疝修补术时要充分评估,做好预防措施,降低术后慢性疼痛的发生率.