Effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease undergoing laparoscopic sleeve gastrectomy combined with fundoplication

doi:10.3877/cma.j.issn.2095-8765.2024.01.011

Abstract

Abstract:

Objective

To investigate the effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease(GERD) undergoing laparoscopic sleeve gastrectomy combined with fundoplication.

Methods

The clinical data of 188 patients diagnosed as metabolic syndrome complicated with GERD who underwent laparoscopic sleeve gastrectomy combined with fundoplication from March 2020 to March 2023 in Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed. Logistic regression method was used to analyze the influence of intraoperative body temperature level on prognosis, and ROC curve was used to analyze the predictive value of intraoperative body temperature level on prognosis of patients.

Results

The intraoperative body temperature of patients with complications was lower than that of patients without complications(36.48 ℃ ± 0.24 ℃ vs 36.67 ℃ ± 0.22 ℃, P=0.002). Logistic regression analysis showed that intraoperative hypothermia was a risk factor for postoperative complications, and the AUC of intraoperative body temperature level in predicting the prognosis of patients was greater than 0.7.

Conclusion

Intraoperative hypothermia is a risk factor for complications after laparoscopic sleeve gastrectomy combined with fundoplication for metabolic syndrome complicated with GERD. Intraoperative hypothermia has high predictive value for prognosis.

Key words: Metabolic syndrome, Gastroesophageal reflux disease, Laparoscopic sleeve gastrectomy, Fundoplication, Body temperature level, Prognosis

Chen Cheng, Cong Zhao, Yuan Jiang, Li Zhang. Effect of intraoperative body temperature on the prognosis of patients with metabolic syndrome complicated with gastroesophageal reflux disease undergoing laparoscopic sleeve gastrectomy combined with fundoplication[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(01): 47-52.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhwsgflbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8765.2024.01.011

https://zhwsgflbdzzz.cma-cmc.com.cn/EN/Y2024/V11/I01/47

Figures/Tables 3

References 27

1	Runkel N, Brydniak R. Surgical treatment of metabolic syndrome[J]. Visc Med, 2016, 32(5): 352-356.
2	Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations[J]. Obes Surg, 2017, 27(1): 2-21.
3	Nasser H, Munie S, Kindel TL, et al. Comparative analysis of robotic versus laparoscopic revisional bariatric surgery: perioperative outcomes from the MBSAQIP database[J]. Surg Obes Relat Dis, 2020, 16: 397-405.
4	刘洋, 李梦伊, 张松海, 等. 大华北减重与代谢手术临床资料数据库年度报告(2018)[J]. 中国实用外科杂志,2019,39(2):149-154.
5	Wozniewska P, Diemieszczyk I, Hady HR. Complications associated with laparoscopic sleeve gastrectomy - a review[J]. Gastroenterol Rev, 2021, 16(1): 5-9.
6	Fletcheer R, Deal R, Kubasiak J, et al. Predictors of increased length of hospital stay following laparoscopic sleeve gastrectomy from the national surgical quality improvement program[J]. J Gastrointest Surg, 2017, 22 (2): 274-278.
7	Nickel F, De La GarzaJr, Werthmann FS, et al. Predictors of risk and success of obesity surgery[J]. Obesity Facts, 2019, 12(4): 427-439.
8	Haskins In, Nowacki As, Khorgami Z, et al. Should recent smoking be a contraindication for sleeve gastrectomy?[J]. Surg Obes Relat Dis, 2017, 13 (7): 1130-1135.
9	王存川, 张鹏, 赵玉沛.腹腔镜袖状胃切除术操作指南(2018版)[J/OL].中华肥胖与代谢病电子杂志,2018,4(4):196-201.
10	Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes[J]. N Engl J Med, 2017, 376(7): 641-651.
11	Peterli R, Wolnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus roux-y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized swiss multicenter bypass or sleeve study (SM-BOSS)[J]. Ann Surg, 2017, 265 (3): 466-473.
12	Gluszynska P, Diemieszczyk I, Szczerbinski L, et al. Risk factors for early and late complications after laparoscopic sleeve gastrectomy in one-year observation[J]. J Clin Med, 2022, 11 (2):436.
13	马钰栋, 周爱明, 顾德智, 等.腹腔镜袖状胃切除术后早期并发症的影响因素分析[J].中国普外基础与临床杂志,2023,30(5):582-586.
14	Lorente L, Ramon J, Vidal P, et al. Obesity surgery mortality risk score for the prediction of complications after laparoscopic bariatric surgery[J]. Cir Esp (Engl Ed), 2014, 92 (5): 316-323.
15	Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in the elderly: an ACS NSQIP study[J]. J Gastrointest Surg, 2011, 16(1): 35-44.
16	Guetta O, Vakhrushev A, Dukhno O, et al. New results on the safety of laparoscopic sleeve gastrectomy bariatric procedure for type 2 diabetes patients[J]. World J Diabetes, 2019, 10 (2): 78-86.
17	Allum Wh, Blazeby Jm, Griffin SM, et al. Guidelines for the management of oesophageal and gastric cancer[J]. Gut, 2011, 60 (11): 1449-1472.
18	王青峰, 陆晶晶, 鲁生林, 等. 新辅助化疗后行腹腔镜胃癌根治术并发症有关影响因素及预后分析[J]. 临床外科杂志, 2023, 31(9): 860-863.
19	刘萍, 吴梦平, 徐渭, 等. 胃肠恶性肿瘤患者非计划再次手术风险因素分析[J]. 中国病案, 2021, 22(9): 55-59.
20	Blaszak AM, Jalilvand A, Hsueh WA. Adipocytes, innate immunity and obesity: a mini-review[J]. Front Immunol, 2021, 12: 650768.
21	Li S, Pang NN, Yan P, et al.Control of body temperature and immune function in patients undergoing open surgery for gastric cancer[J]. Bosn J Basic Med Sci, 2018, 18(3): 289-296.
22	肖瑶, 杨慧, 胡娟娟, 等．围手术期低体温预防及管理的循证实践[J].中华护理杂志,2019,54(9):1302-1307.
23	曹晖, 陈亚进, 顾小萍, 等.中国加速康复外科临床实践指南(2021版)[J].中国实用外科杂志,2021,41(9):961-992.
24	孔珊珊, 申海艳, 郑洪, 等.医护人员实施剖宫产术中体温管理影响因素的质性研究[J].护理学杂志,2020,35(23):31-34, 41.
25	李玉梅, 张宏晨, 陈晓东, 等.围术期低体温风险预测模型的研究进展[J].护理研究,2021,35(17):3107-3110.
26	王会, 张倩, 万一聪.初始室温控制对卵巢癌开腹手术患者术中体温变化的影响[J].护士进修杂志,2021,36(19):1772-1776.
27	Sun Y, Jia LL, Yu WL, et al. The changes of intraoperative body temperature in adult liver transplantation: a retrospective study[J]. Hepatobiliary Pancreat Dis Int,2018,17(6):496-501.

临床资料	并发症组（15例）	非并发症组（173例）	χ²/t值	P值
年龄(岁，)	36.73±10.68	35.64±8.78	0.454	0.650
性别[例(%)]			0.144	0.704
男性	7(46.7)	72(41.6)
女性	8(53.3)	101(58.4)
BMI(kg/m²，)	37.97±4.69	40.18±7.53	-1.118	0.265
合并症[例(%)]			3.957	0.047
是	6(40.0)	32(18.5)
否	9(60.0)	141(81.5)
吸烟史[例(%)]			0.621	0.431
是	7(46.7)	63（36.4）
否	8(53.3)	110（63.6）
酗酒史[例(%)]			4.373	0.037
是	5(33.3)	23（13.3）
否	10(66.7)	150（86.7）
ASA分级			5.203	0.023
I/II级	10(66.7)	152（87.9）
III/IV级	5(33.3)	21（12.1）
手术时间(min,)	170.80±8.08	163.41±11.87	2.361	0.019
出血量(ml,)	89.40±5.90	82.65±10.33	2.494	0.014
术中体温水平(℃,)	36.48±0.24	36.67±0.22	-3.182	0.002

临床资料	并发症组（15例）	非并发症组（173例）	χ²/t值	P值
年龄(岁，)	36.73±10.68	35.64±8.78	0.454	0.650
性别[例(%)]			0.144	0.704
男性	7(46.7)	72(41.6)
女性	8(53.3)	101(58.4)
BMI(kg/m²，)	37.97±4.69	40.18±7.53	-1.118	0.265
合并症[例(%)]			3.957	0.047
是	6(40.0)	32(18.5)
否	9(60.0)	141(81.5)
吸烟史[例(%)]			0.621	0.431
是	7(46.7)	63（36.4）
否	8(53.3)	110（63.6）
酗酒史[例(%)]			4.373	0.037
是	5(33.3)	23（13.3）
否	10(66.7)	150（86.7）
ASA分级			5.203	0.023
I/II级	10(66.7)	152（87.9）
III/IV级	5(33.3)	21（12.1）
手术时间(min,)	170.80±8.08	163.41±11.87	2.361	0.019
出血量(ml,)	89.40±5.90	82.65±10.33	2.494	0.014
术中体温水平(℃,)	36.48±0.24	36.67±0.22	-3.182	0.002

因素	β	SE	Wald χ²	P值	OR	95%CI
合并症	2.028	0.766	7.015	0.008	7.601	1.694~34.099
酗酒史	1.619	0.792	4.182	0.041	5.046	1.070~23.809
ASA分级	-1.659	0.729	5.170	0.023	0.190	0.046~0.795
手术时间	0.063	0.031	4.074	0.044	1.066	1.002~1.133
出血量	0.132	0.058	5.110	0.024	1.141	1.018~1.280
术中体温水平	-4.274	1.613	7.019	0.008	0.014	0.001~0.329

因素	β	SE	Wald χ²	P值	OR	95%CI
合并症	2.028	0.766	7.015	0.008	7.601	1.694~34.099
酗酒史	1.619	0.792	4.182	0.041	5.046	1.070~23.809
ASA分级	-1.659	0.729	5.170	0.023	0.190	0.046~0.795
手术时间	0.063	0.031	4.074	0.044	1.066	1.002~1.133
出血量	0.132	0.058	5.110	0.024	1.141	1.018~1.280
术中体温水平	-4.274	1.613	7.019	0.008	0.014	0.001~0.329

[1]	Jianna Sun, Lingjun Kong, Chongxi Ren, Kun Mu, Xiaorui Wang. Prognostic analysis of 266 patients with stage IV breast cancer undergoing surgery for the first time [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 502-505.
[2]	Qinggang Yuan, Lixiang Liu, Liang Zhang, Shizhen Zhou, Bo Gao, Chao Ding, Wenxian Guan. Urea-creatinine ratio (UCR) predicts the long-term prognosis of colorectal cancer patients after surgery [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 506-509.
[3]	Meng Li, La Jiang, Lei Dong, Qing Wu, Ben Li Jia. Clinical study of laparoscopic gastric sleeve resection in the treatment of obesity complicated with type 2 diabetes mellitus and fatty pancreas [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 554-557.
[4]	Fu Huang, Qian Wang, Xiangren Jin, Yunchuan Tang. Study on the relationship between the expression of VEGFR2 and miR-27a-5p in gastric cancer tissues and clinicopathological parameters and prognosis [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 558-561.
[5]	Bo Yang, Xu Hu, Jinyan He, Ming Xie. Research status of laparoscopic sleeve gastrectomy tube fixation [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(04): 452-455.
[6]	Daming Cai, Xiaofeng Lu, Xingzhou Wang, Meng Wang, Song Liu, Xuefeng Xia, Xiaofei Shen, Junfeng Du, Wenxian Guan. Predictive value of tertiary lymphoid structures in the prognosis of patients with gastric neuroendocrine neoplasms [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(04): 401-405.
[7]	DaRebai· ReDati, Lin Liu, Weimin Zhao, Tao Meng, Cheng Lei, Bo Jin, Jianjun Bi, Xinyu Li, Haijiang Wang. Clinical observation of lateral lymph node dissection after neoadjuvant chemoradiotherapy for middle and low rectal cancer [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(04): 415-418.
[8]	Yong Li, Tianming Peng, Qianqian Wang, Yuchun Chen, Xiaoyong Pu, Jiumin Liu. Construction and analysis of a prognostic model of bladder cancer based on anoikis-related genes [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 331-339.
[9]	Chengbo Qian, Huming Yin, Feng Qiu, Jianquan Hou, Yuhua Huang, Xuedong Wei. Evaluation of laparoscopic radical cystectomy with W-shaped ileal neobladder in the elderly [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 346-352.
[10]	Bin Zhang, Daiyu Sun, Xin Hu, Fei Han, Jiuming Li, Gongyu Li, Weili Wu, Baofu Feng, Guohui Peng. Evaluation and comparison of the accuracy of the stone scoring systems in the prediction of stone-free rate after retrograde intrarenal surgery in different surgical experiences [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 353-360.
[11]	Zhongwen Liu, Chang Liu, Yang Gao, Dong Liu, Shiqing Lin, Jianhua Yang, Fuyi Zhao. Correlation of urinary microRNA-326 with the prognosis of bladder cancer patients treated with radical cystectomy [J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 386-391.
[12]	Xiujun Yang, Mengying Cui, Shui Liu, Jiyao Sheng, Dan Zhang. Construction and validation of prognostic nomogram for patients with pancreatic neuroendocrine carcinoma on the head of pancreas based on SEER database [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(04): 520-525.
[13]	Yao Zeng, Qin Xie, Xianyu Chen, Pinggen Wang, Lingqiu Mao, Danling He, Fei Du, Xiyan Zheng, Hanxi He. Relationship between CDC42EP2 gene and prognosis of hepatocellular carcinoma, immune cell infiltration and its effects on cell migration and invasion [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(03): 363-369.
[14]	Xiaolong Wang, Jie Wu, Shuwei Duan, Chaohui Wang, Na Pan, Yuanyuan Bai, Hangtian Li, Guangyan Cai. Effect of different levels of physical activity on the prognosis of patients with chronic kidney disease [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(03): 121-128.
[15]	Xiaojiu Tang, Man Hu, Bijun Xu, Ya Xiao. Study on the correlation between the severity of obesity combined with gastroesophageal reflux disease patients and their anxiety, depression and nutritional status [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(04): 360-364.

Please choose a citation manager

Content to export