Analysis of risk factors for dysphagia in patients after laparoscopic radical gastrectomy.

Abstract

Background: Gastric cancer is among the most prevalent malignancies worldwide. Despite significant advancements in chemoradiotherapy, targeted therapy, and neoadjuvant therapy, conventional surgical intervention remains the cornerstone of gastric cancer management. Improvements in surgical techniques, coupled with the use of staplers and other advanced instruments, have substantially reduced the incidence of complications and mortality following gastric cancer surgery. However, dysphagia remains a common postoperative complication.

Aim: To retrospectively investigate the potential factors contributing to dysphagia in patients who have undergone laparoscopic radical gastrectomy for gastric cancer and to explore effective strategies for its postoperative management.

Methods: In this retrospective study, we analyzed data from patients who underwent elective laparoscopic total gastrectomy at Lihuili Hospital, Ningbo University, between January 2018 and May 2022. A total of 115 eligible postoperative patients were included. Postoperatively, patients completed questionnaires and were categorized into two groups based on their responses: The dysphagia group (Eating Assessment Tool-10 score ≥ 3) and the non-dysphagia group (Eating Assessment Tool-10 score < 3). Risk factors associated with dysphagia following total gastrectomy were assessed using χ ² tests, Fisher's exact tests, t-tests, Pearson correlation coefficients, and univariate and multivariate regression analyses.

Results: Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low albumin (ALB) levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.

Conclusion: Univariate analysis revealed that anastomotic style, low serum ALB levels, advanced age, and prolonged intubation time were significantly associated with postoperative dysphagia in gastric cancer patients. Multivariate analysis further identified anastomotic style, prolonged intubation time, advanced age, and low ALB levels as independent risk factors for postoperative dysphagia. Implementing targeted preventive measures for high-risk groups may significantly enhance postoperative quality of life.