Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2019; 25(38): 5838-5849
Published online Oct 14, 2019. doi: 10.3748/wjg.v25.i38.5838
Nomogram to predict prolonged postoperative ileus after gastrectomy in gastric cancer
Wen-Quan Liang, Ke-Cheng Zhang, Jian-Xin Cui, Hong-Qing Xi, Ai-Zhen Cai, Ji-Yang Li, Yu-Hua Liu, Jie Liu, Wang Zhang, Peng-Peng Wang, Bo Wei, Lin Chen
Wen-Quan Liang, Ke-Cheng Zhang, Jian-Xin Cui, Hong-Qing Xi, Ai-Zhen Cai, Ji-Yang Li, Wang Zhang, Peng-Peng Wang, Bo Wei, Lin Chen, Department of General Surgery & Institute of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Yu-Hua Liu, Institute of Army Hospital Management, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Jie Liu, Department of Vascular and Endovascular Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Chen L, Wei B, Liang WQ, Zhang KC, and Cui JX designed the study; Liang WQ, Zhang KC, and Cui JX wrote the manuscript; Xi HQ and Cai AZ contributed to the patient material; Li JY and Liu YH collected the clinical data; Liu J, Zhang W, and Wang PP contributed to data analysis and validation; Liang WQ, Zhang KC, and Cui JX contributed equally to this work.
Supported by the National Nature Science Foundation of China, No. 81672319, No. 81602507, and No. 81773135; the National Key Research and Development Plan, No. 2017YFC0908300; and Beijing Nova Program, No. Z181100006218011.
Institutional review board statement: The study was approved by the Research Ethics Committee of the Chinese People’s Liberation Army General Hospital.
Informed consent statement: All study participants provided written consent prior to study enrollment.
Conflict-of-interest statement: All the authors have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected byan in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lin Chen, MA, MD, PhD, Chief Doctor, Professor, Department of General Surgery & Institute of General Surgery, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China. chenlin@301hospital.com.cn
Telephone: +86-10-66937164 Fax: +86-10-68181689
Received: July 15, 2019
Peer-review started: July 16, 2019
First decision: August 2, 2019
Revised: September 5, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 14, 2019
ARTICLE HIGHLIGHTS
Research background

Prolonged postoperative ileus (PPOI) is one of the common complications in gastric cancer patients who underwent gastrectomy. PPOI is an essential contributor to cause the increase of hospitalization expense and extension of hospitalization time.

Research motivation

For the research of PPOI, most of previous studies were focused on colorectal cancer. Evidence in gastric cancer is scanty and needs further study.

Research objectives

This study aimed to evaluate the risk factors for PPOI after gastrectomy in gastric cancer and put forward a prediction model for clinical practitioners.

Research methods

In this retrospective study, we performed univariate and multivariable logistic regression analyses to detect the relationship between variables and PPOI. We established a nomogram model for PPOI following a backward step-down selection process.

Research results

The incidence of PPOI was 19.75% in patients with gastrectomy. Age, postoperative opioid analgesic, surgical methods, and tumor stage were independent risk factors of PPOI. A nomogram was established and had a good performance. The nomogram was further validated using internal bootstrap validation, and the decision curve analysis demonstrated good positive net benefits of this model.

Research conclusions

The novel nomogram might serve as an essential early warning sign of PPOI in gastric cancer patients and thus will help doctors and nurses take appropriate measures.

Research perspectives

Further studies are needed to validate this predictive nomogram model, and some basic medical studies are meaningful to investigate the mechanism of PPOI.