{"title":"Impact of diabetes on recovery after radical gastrectomy for gastric cancer: A retrospective cohort study.","authors":"Lei Zhao, Lan Wei, Xiao-Lu Fei","doi":"10.4240/wjgs.v17.i3.100763","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains a significant global health concern. Radical gastrectomy is the primary curative treatment. Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer, including radical gastrectomy. Previous studies have suggested that diabetes can negatively affect postoperative outcomes, such as wound healing, infection rates, and overall recovery. However, the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood. evaluate the influence of diabetes on postoperative recovery, including hospital stay duration, complications, and readmission rates, in patients undergoing gastrectomy for gastric cancer. Understanding these effects could help optimize perioperative management and improve patient outcomes.</p><p><strong>Aim: </strong>To investigate the impact of diabetes on recovery after radical gastrectomy for gastric cancer and associated postoperative outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital, Capital Medical University, Beijing, China. We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020. The patients were divided into the diabetes and non-diabetes groups. The main outcomes included length of hospital stay, postoperative complications, and 30-day readmission rate. Secondary outcomes included quality of life indicators. Propensity score matching was used to adjust for potential confounding factors.</p><p><strong>Results: </strong>A total of 1210 patients were included in the study, with 302 diabetic patients and 908 non-diabetic patients. After propensity score matching, 280 patients were included in each group. Diabetic patients demonstrated significantly longer hospital stays (mean difference 2.3 days, 95%CI: 1.7-2.9, <i>P</i> < 0.001) and higher rates of postoperative complications (OR 1.68, 95%CI: 1.32-2.14, <i>P</i> < 0.001). The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group (12.5% <i>vs</i> 7.8%, <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay, increased postoperative complications, and higher readmission rates, thus requiring optimized perioperative management strategies.</p>","PeriodicalId":23759,"journal":{"name":"World Journal of Gastrointestinal Surgery","volume":"17 3","pages":"100763"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948120/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4240/wjgs.v17.i3.100763","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Gastric cancer remains a significant global health concern. Radical gastrectomy is the primary curative treatment. Diabetes mellitus is a common comorbidity in patients undergoing surgery for gastric cancer, including radical gastrectomy. Previous studies have suggested that diabetes can negatively affect postoperative outcomes, such as wound healing, infection rates, and overall recovery. However, the specific impact of diabetes on recovery after radical gastrectomy for gastric cancer remains poorly understood. evaluate the influence of diabetes on postoperative recovery, including hospital stay duration, complications, and readmission rates, in patients undergoing gastrectomy for gastric cancer. Understanding these effects could help optimize perioperative management and improve patient outcomes.
Aim: To investigate the impact of diabetes on recovery after radical gastrectomy for gastric cancer and associated postoperative outcomes.
Methods: This retrospective cohort study was performed at the Endocrinology Department of Xuanwu Hospital, Capital Medical University, Beijing, China. We examined patients who underwent radical gastrectomy for cancer between January 2010 and December 2020. The patients were divided into the diabetes and non-diabetes groups. The main outcomes included length of hospital stay, postoperative complications, and 30-day readmission rate. Secondary outcomes included quality of life indicators. Propensity score matching was used to adjust for potential confounding factors.
Results: A total of 1210 patients were included in the study, with 302 diabetic patients and 908 non-diabetic patients. After propensity score matching, 280 patients were included in each group. Diabetic patients demonstrated significantly longer hospital stays (mean difference 2.3 days, 95%CI: 1.7-2.9, P < 0.001) and higher rates of postoperative complications (OR 1.68, 95%CI: 1.32-2.14, P < 0.001). The 30-day readmission rate was also higher in the diabetic group as compared to the non-diabetic group (12.5% vs 7.8%, P = 0.02).
Conclusion: Patients with diabetes mellitus undergoing radical gastrectomy for gastric cancer experience prolonged hospital stay, increased postoperative complications, and higher readmission rates, thus requiring optimized perioperative management strategies.
背景:胃癌仍然是一个重要的全球健康问题。根治性胃切除术是主要的治疗方法。糖尿病是胃癌手术(包括胃癌根治术)患者的常见合并症。先前的研究表明,糖尿病会对术后结果产生负面影响,如伤口愈合、感染率和整体恢复。然而,糖尿病对胃癌根治术后恢复的具体影响尚不清楚。评估糖尿病对胃癌切除术患者术后恢复的影响,包括住院时间、并发症和再入院率。了解这些影响有助于优化围手术期管理和改善患者预后。目的:探讨糖尿病对胃癌根治术后恢复及相关预后的影响。方法:回顾性队列研究在首都医科大学附属宣武医院内分泌科进行。我们调查了2010年1月至2020年12月期间因癌症接受根治性胃切除术的患者。这些患者被分为糖尿病组和非糖尿病组。主要结局包括住院时间、术后并发症和30天再入院率。次要结局包括生活质量指标。倾向评分匹配用于调整潜在的混杂因素。结果:共纳入1210例患者,其中糖尿病患者302例,非糖尿病患者908例。倾向评分匹配后,每组纳入280例患者。糖尿病患者的住院时间明显延长(平均差2.3天,95%CI: 1.7 ~ 2.9, P < 0.001),术后并发症发生率明显增加(OR 1.68, 95%CI: 1.32 ~ 2.14, P < 0.001)。糖尿病组的30天再入院率也高于非糖尿病组(12.5% vs 7.8%, P = 0.02)。结论:糖尿病胃癌根治术患者住院时间延长,术后并发症增加,再入院率高,需要优化围手术期管理策略。