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Nomogram for predicting early complications after distal gastrectomy.

Biao Zhang¹, Qing Zhu¹, Zhi-Peng Ji²

¹Department of Gastrointestinal Surgery, Second Hospital of Shandong University, Jinan 250033, Shandong Province, China.

World Journal of Gastrointestinal Surgery

|December 19, 2023

Summary

This study identified key risk factors for early postoperative complications following gastric cancer (GC) distal gastrectomy. A validated nomogram prediction model can help target high-risk patients for interventions, reducing complications.

Keywords:

Blood transfusion Gastroenterostomy Nomograms Postoperative complications Risk factors Stomach neoplasms

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Area of Science:

Oncology
Surgical Gastroenterology
Medical Informatics

Background:

Postoperative morbidity in gastric cancer (GC) patients is a critical concern in perioperative care.
Minimizing complications after GC surgery is essential for patient recovery and treatment success.

Purpose of the Study:

To identify independent risk factors for early postoperative complications after distal gastrectomy for GC.
To develop and validate a predictive nomogram model for these complications.

Main Methods:

Retrospective analysis of 131 GC patients undergoing distal gastrectomy.
Univariate and multivariate logistic regression to identify risk factors.
Nomogram construction and validation using internal and external datasets (n=45).
Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) for model evaluation.

Main Results:

Hypertension, diabetes, prior abdominal surgery, and perioperative blood transfusion were identified as independent predictors of complications.
The nomogram demonstrated good predictive performance with an area under the curve (AUC) of 0.843 (modeling) and 0.877 (validation).
The model showed high sensitivity (0.762-0.778) and specificity (0.809-0.944), with good calibration and clinical utility.

Conclusions:

A nomogram based on identified risk factors effectively predicts postoperative complications after distal gastrectomy for GC.
This tool can aid in perioperative intervention strategies for high-risk patient groups.
Implementing the nomogram can potentially reduce the incidence of postoperative complications in GC patients.