Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 100763
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.100763
Impact of diabetes on recovery after radical gastrectomy for gastric cancer: A retrospective cohort study
Lei Zhao, Lan Wei, Xiao-Lu Fei
Lei Zhao, Department of Endocrine, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Lan Wei, Xiao-Lu Fei, Information Center, Xuanwu Hospital Capital Medical University, Beijing 100053, China
Author contributions: Zhao L designed this study; Wei L contributed to data collection, and Zhao L and Wei L jointly drafted the initial draft and formal analysis; Fei XL provided guidance and contributed to the methodology and visualization of this study. Zhao L, Wei L, and Fei XL jointly validated the study and edited the entire content of the manuscript.
Institutional review board statement: This study has been reviewed by the ethics committee of Xuanwu Hospital, Capital Medical University.
Informed consent statement: This study has been approved by the patient and guardian.
Conflict-of-interest statement: All authors declare that there is no disclosure of any conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Zhao, MD, Associate Chief Physician, Department of Endocrine, Xuanwu Hospital Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. zhaolei8346@126.com
Received: December 5, 2024
Revised: January 7, 2025
Accepted: January 23, 2025
Published online: March 27, 2025
Processing time: 80 Days and 17.8 Hours
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.

Keywords: Gastric cancer; Diabetes mellitus; Radical gastrectomy; Postoperative recovery; Complications

Core Tip: This study evaluated the effect of diabetes mellitus on postoperative recovery in patients with gastric cancer who underwent radical gastrectomy. Diabetic patients experienced longer hospital stays, higher rates of postoperative complications, and increased 30-day readmission rates than non-diabetic patients. These results underscore the importance of tailored perioperative management strategies to improve the outcomes of patients with diabetes undergoing surgical interventions. Optimal care is essential to mitigate the adverse effects of diabetes on recovery following gastrectomy.