Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2021; 9(18): 4644-4653
Published online Jun 26, 2021. doi: 10.12998/wjcc.v9.i18.4644
Risk factors for postoperative delayed gastric emptying in ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Guang-Xia Cui, Zi-Jun Wang, Jin Zhao, Ping Gong, Shuai-Hong Zhao, Xiao-Xue Wang, Wen-Pei Bai, Yan Li
Guang-Xia Cui, Zi-Jun Wang, Jin Zhao, Ping Gong, Shuai-Hong Zhao, Xiao-Xue Wang, Wen-Pei Bai, Department of Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Yan Li, Department of Peritoneal Caner Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Author contributions: Cui GX developed the methods, performed the formal analyses and data curation, and wrote the original draft; Wang ZJ performed the data curation and the investigations; Zhao J, Gong P, and Zhao SH performed the data curation, developed the methods, and conducted the investigations; Wang XX performed the formal analyses; Bai WP and Li Y participated in the conceptualization, methodology, writing, reviewing and editing of the manuscript, and funding acquisition; All authors have read and approved the final manuscript.
Supported by Beijing Natural Science Foundation, No. 7202075 and “Beijing Hospitals Authority” Ascent Plan, No. DFL20190701.
Institutional review board statement: All the patients provided written informed consent before enrollment and the study was reviewed and approved by the ethics committee and institutional review board of Beijing Shijitan Hospital, Capital Medical University.
Informed consent statement: All the patients provided written informed consent before enrollment.
Conflict-of-interest statement: Neither the submitted paper nor any similar paper, in whole or in part, has been submitted to or published in any other scientific journal. All authors of this paper have read and approved the final submitted version and are aware that they are listed as an author on the paper. There are no financial or other interests with regard to the submitted manuscript that might be construed as a conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The guidelines of the STROBE Statement have been adopted in this study.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Pei Bai, PhD, Chief Physician, Director, Doctor, Full Professor, Professor, Surgeon, Department of Gynaecology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Yangfangdian Street, Haidian District, Beijing 100038, China. baiwp@bjsjth.cn
Received: December 19, 2020
Peer-review started: December 19, 2020
First decision: January 23, 2021
Revised: January 23, 2021
Accepted: March 17, 2021
Article in press: March 17, 2021
Published online: June 26, 2021
ARTICLE HIGHLIGHTS
Research background

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) are alternatives for ovarian cancer. Delayed gastric emptying (DGE), a common complication of this procedure, can cause discomfort and decrease quality of life postoperatively. However, little attention has been given to this complication.

Research motivation

Though not life-threatening, DGE can increase the duration of postoperative hospitalization, decrease quality of life, and even affect the long-term prognosis of patients after CRS-HIPEC. More research is needed to elucidate the pathophysiology, etiology and treatment of DGE.

Research objectives

The aim of this study was to identify the risk factors for DGE in patients with ovarian cancer treated with CRS-HIPEC. Identifying patients at increased risk for DGE may aid patient selection as well as postoperative gastrointestinal management.

Research methods

A retrospective study was conducted, and risk factors for DGE were analyzed using univariate and multivariate analyses.

Research results

Age ≥ 70 years and intraoperative hemorrhage ≥ 800 mL were independently associated with postoperative DGE after CRS-HIPEC. Perigastric and gastric dissection is known to be the greatest risk factor for DGE. However, it was not found to be related to DGE in our study. The possible reason may be that the sample size was too small.

Research conclusions

Postoperative gastrointestinal management, including prolonged nasogastric intubation, should be strengthened for patients over 70 years or with intraoperative bleeding exceeding 800 mL.

Research perspectives

Large-sample RCTs are needed to further identify the risk factors and management of DGE.