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©The Author(s) 2024.
World J Gastroenterol. Jan 7, 2024; 30(1): 79-90
Published online Jan 7, 2024. doi: 10.3748/wjg.v30.i1.79
Published online Jan 7, 2024. doi: 10.3748/wjg.v30.i1.79
Table 1 Demographic and clinical characteristics of the training group and validation groups (mean ± SD)
Characteristic | Training group | Validation group | ||||
LGC (n = 998) | LTG (n = 572) | LDG (n = 426) | LGC (n = 398) | LTG (n = 165) | LDG (n = 233) | |
Age | 59.8 (11.31) | 60.0 (11.22) | 59.6 (11.44) | 57.8 (12.4) | 59.2 (12.2) | 57.0 (12.4) |
Gender | ||||||
Female | 307 | 156 | 151 | 173 | 45 | 82 |
male | 691 | 416 | 275 | 342 | 120 | 151 |
BMI | 22.6 (3.2) | 22.9 (3.2) | 22.3 (3.2) | 22.6 (3.4) | 22.7 (3.6) | 22.5 (3.4) |
ASA score | ||||||
2 | 964 | 556 | 408 | 365 | 148 | 217 |
3 | 34 | 16 | 18 | 33 | 17 | 16 |
ECOG score | ||||||
0 | 810 | 460 | 350 | 142 | 69 | 73 |
1 | 158 | 98 | 60 | 231 | 89 | 142 |
2 | 30 | 14 | 16 | 25 | 7 | 18 |
Severe heart disease | 4 | 1 | 3 | 22 | 17 | 5 |
Severe lung disease | 10 | 5 | 5 | 18 | 12 | 6 |
Hypertension | 140 | 71 | 69 | 78 | 39 | 39 |
Diabetes | 67 | 30 | 37 | 52 | 27 | 25 |
Operative time (min) | 240 (63.0) | 246.8 (73.1) | 230.9 (44.6) | 280.9 (76.4) | 308.0 (86.1) | 267.2 (68.9) |
Bleeding volume (min) | 130.5 (115.4) | 147.8 (128.5) | 107.3 (90.0) | 54.3 (57.6) | 78.7 (67.4) | 57.9 (51.6) |
Blood transfusion (mL) | 25.5 (138.1) | 34.3 (172.3) | 13.62 (67.9) | 19.0 (132.4) | 11.0 (65.1) | 22.0 (154.0) |
Complication | 139 | 64 | 75 | 78 | 51 | 27 |
ClavienDindo | ||||||
0 | 859 | 508 | 351 | 320 | 114 | 206 |
1 | 14 | 5 | 9 | 17 | 10 | 7 |
2 | 93 | 34 | 59 | 56 | 38 | 18 |
3 | 29 | 24 | 5 | 5 | 3 | 2 |
4 | 3 | 1 | 2 | 0 | 0 | 0 |
Table 2 Incidence of complications in the training group and validation groups
Training group | Validation group | |
Complication | 164 | 78 |
Anastomotic leakage | 23 | 11 |
Anastomotic stricture | 5 | 5 |
Anastomotic bleeding | 6 | 0 |
Pancreatic fistula | 3 | 0 |
Gastric and Intestinal stasis | 10 | 0 |
Bleeding of peritoneal cavity | 7 | 1 |
Surgical incision infection or fat liquefaction | 18 | 3 |
Pulmonary infection | 42 | 5 |
Abdominal infection | 27 | 29 |
Sepsis | 5 | 0 |
Urinary tract infection | 1 | 13 |
Intestinal obstruction | 14 | 7 |
Lymphorrhea | 10 | 4 |
Deep vein thrombosis | 1 | 1 |
Pulmonary embolism | 1 | 1 |
Cardiac arrhythmia | 0 | 0 |
Biliary leakage | 1 | 0 |
Table 3 Univariate analysis of severe complications after laparoscopic distal gastrectomy in gastric cancer patients
Variate | No-severe complication (%) | Severe complication (%) | t/χ2 | P value | OR | 95%CI |
Age group | ||||||
Age ≤ 65 | 239 | 38 | 1.905 | 0.168 | ||
Age > 65 | 121 | 28 | 1.455 | 0.852-2.485 | ||
Gender | ||||||
Male | 234 | 41 | 0.095 | 0.758 | ||
Female | 126 | 25 | 1.132 | 0.658-1.948 | ||
BMI group | ||||||
BMI ≤ 28 | 347 | 57 | 9.49 | 0.002 | ||
BMI > 28 | 13 | 9 | 4.215 | 1.722-10.313 | ||
Hb | 129.7 ± 26.6 | 126.8 ± 26.2 | 0.797 | 0.424 | 0.996 | 0.986-1.006 |
ALB | 40.7 ± 4.85 | 40.3 ± 4.03 | 0.707 | 0.48 | 0.98 | 0.927-1.036 |
Tumor size | 3.2 ± 1.8 | 3.5 ± 2.0 | -1.346 | 0.179 | 1.101 | 0.967-1.266 |
Bleeding volume | 103.3 ± 89.2 | 128.6 ± 91.9 | -2.109 | 0.036 | 1.003 | 1.000-1.005 |
Operative time | 230.7 ± 45.1 | 232.4 ± 42.2 | -0.282 | 0.778 | 1.001 | 0.995-1.007 |
Blood transfusion | 6.9 ± 49.86 | 50.00 ± 121.8 | -27.381 | < 0.001 | 1.006 | 1.003-1.010 |
Severe heart disease | ||||||
No | 359 | 64 | 2.748 | 0.064 | ||
Yes | 1 | 2 | 11.219 | 1.002-125.553 | ||
Severe lung disease | ||||||
No | 358 | 63 | 4.601 | 0.032 | ||
Yes | 2 | 3 | 8.524 | 1.396-52.039 | ||
Hypertension | ||||||
No | 302 | 55 | 0.013 | 0.91 | ||
Yes | 58 | 11 | 1.041 | 0.541-2.109 | ||
Diabetes | ||||||
No | 329 | 60 | 0.016 | 0.899 | ||
Yes | 31 | 6 | 1.061 | 0.424-2.654 | ||
Surgerical type | ||||||
Totally | 82 | 20 | 1.734 | 0.188 | ||
Assisted | 278 | 46 | 0.678 | 0.380-1.212 | ||
Reconstruction | ||||||
Billroth I | 90 | 12 | 6.133 | 0.105 | ||
Billroth II | 106 | 26 | 1.840 | 0.878-3.854 | ||
Roux-en-Y | 113 | 24 | 1.593 | 0.755-3.360 | ||
Billroth II + Braun | 51 | 4 | 0.588 | 0.180-19.19 | ||
ECOG score | ||||||
0 | 323 | 27 | 95.605 | < 0.001 | ||
1 | 34 | 26 | 9.148 | 4.804-17.421 | ||
2 | 3 | 13 | 51.840 | 13.913-193.157 | ||
ASA score | ||||||
2 | 353 | 55 | 29.802 | < 0.001 | 10.086 | 3.750-27.124 |
Table 4 Univariate analysis of severe complications after laparoscopic total gastrectomy in gastric cancer patients
Variate | No-severe complication (%) | Severe complication (%) | t/χ2 | P value | OR | 95%CI |
Age group | ||||||
Age < 65 | 332 | 30 | 4.381 | 0.036 | ||
Age ≥ 65 | 181 | 29 | 1.733 | 1.032-3.047 | ||
Gender | ||||||
Male | 372 | 44 | 0.113 | 0.736 | ||
Female | 141 | 15 | 0.899 | 0.485-1.667 | ||
BMI group | ||||||
BMI ≤ 28 | 481 | 53 | 1.319 | 0.251 | ||
BMI > 28 | 32 | 6 | 1.702 | 0.680-4.257 | ||
Hb | 129.1 ± 25.1 | 135.2 ± 25.7 | -1.754 | 0.08 | 1.01 | 0.999-1.021 |
ALB | 40.4 ± 3.1 | 39.7 ± 3.2 | 1.664 | 0.097 | 0.928 | 0.851-1.013 |
Tumor size | 4.0 ± 2.2 | 3.8 ± 1.9 | 0.674 | 0.501 | 0.95 | 0.826-1.092 |
Bleeding volume | 150.2 ± 133.5 | 130.2 ± 70.0 | 1.114 | 0.255 | 0.998 | 0.995-1.001 |
Operative time | 248.9 ± 73.9 | 229.0 ± 62.5 | 1.983 | 0.048 | 0.996 | 0.991-1.000 |
Intraoperative blood transfusion | 37.1 ± 180.8 | 10.17 ± 54.8 | {0.099} | 0.754 | 0.998 | 0.995-1.002 |
Severe heart disease | ||||||
No | 512 | 59 | 0.115 | 0.734 | ||
Yes | 1 | 0 | ||||
Severe lung disease | ||||||
No | 511 | 56 | 13.461 | < 0.001 | ||
Yes | 2 | 3 | 13.687 | 2.239-83.665 | ||
Hypertension | ||||||
No | 452 | 49 | 1.245 | 0.264 | ||
Yes | 61 | 10 | 1.512 | 0.728-3.140 | ||
Diabetes | ||||||
No | 489 | 53 | 3.21 | 0.073 | ||
Yes | 24 | 6 | 2.307 | 0.902-5.896 | ||
Surgerical type | ||||||
totally | 230 | 35 | 4.467 | 0.035 | ||
assisted | 283 | 24 | 0.557 | 0.322-0.964 | ||
ECOG | ||||||
0 | 426 | 34 | 22.379 | < 0.001 | ||
1 | 77 | 21 | 3.417 | 1.883-6.199 | ||
2 | 10 | 4 | 5.012 | 1.493-16.824 | ||
ASA | ||||||
2 | 505 | 51 | 28.024 | < 0.001 | ||
3 | 8 | 8 | 9.902 | 3.566-27.499 |
- Citation: Hong QQ, Yan S, Zhao YL, Fan L, Yang L, Zhang WB, Liu H, Lin HX, Zhang J, Ye ZJ, Shen X, Cai LS, Zhang GW, Zhu JM, Ji G, Chen JP, Wang W, Li ZR, Zhu JT, Li GX, You J. Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer. World J Gastroenterol 2024; 30(1): 79-90
- URL: https://www.wjgnet.com/1007-9327/full/v30/i1/79.htm
- DOI: https://dx.doi.org/10.3748/wjg.v30.i1.79