The impact of early postoperative stress hyperglycemia on postoperative complications in non-type 2 diabetic patients with gastric cancer

CHENG Yi-fan; TIAN Zhen; ZHOU Jia-jie; LI Rui-qi; ZHAO Shuai; WANG Jie; FU Ya-yan; SUN Qian-nan; WAGN Dao-rong

doi:10.19538/j.cjps.issn1005-2208.2026.04.22

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Chinese Journal of Practical Surgery ›› 2026, Vol. 46 ›› Issue (4) : 516-521. DOI: 10.19538/j.cjps.issn1005-2208.2026.04.22

The impact of early postoperative stress hyperglycemia on postoperative complications in non-type 2 diabetic patients with gastric cancer

CHENG Yi-fan ¹^,²^,³ ,
TIAN Zhen ¹^,²^,³ ,
ZHOU Jia-jie ¹^,²^,³ ,
LI Rui-qi ¹^,²^,³ ,
ZHAO Shuai ¹^,²^,³ ,
WANG Jie ²^,³ ,
FU Ya-yan ²^,³ ,
SUN Qian-nan ²^,³ ,
WAGN Dao-rong ¹^,²^,³

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Abstract

Objective To investigate the impact of early postoperative stress hyperglycemia (SHG) on postoperative complications in gastric cancer patients without a history of type 2 diabetes mellitus, and to analyze the associations of peak blood glucose level and SHG duration with prognosis. Methods A retrospective analysis was conducted on the clinical data of 455 gastric cancer patients without a history of type 2 diabetes mellitus who underwent laparoscopic radical gastrectomy at the Department of Gastrointestinal Surgery, Northern Jiangsu People’s Hospital, between January 2022 and March 2024. According to whether SHG occurred after surgery, the patients were divided into a SHG group (n=113) and a non-SHG group (n=342). The incidence and severity of postoperative complications were compared between the two groups, and multivariate logistic regression analysis was used to identify independent risk factors. In addition, SHG patients were stratified according to peak blood glucose level and duration of SHG for further analysis. Results The incidence of postoperative complications was significantly higher in the SHG group than in the non-SHG group (46.9% vs. 23.1%, P<0.001). Multivariate analysis showed that age (OR=2.262, P=0.002), operation time (OR=1.876, P=0.005), and SHG (OR=2.355, P=0.004) were independent risk factors for postoperative complications. The incidences of incision infection, pulmonary infection, intestinal obstruction, and anastomotic leakage were significantly higher in the SHG group (P<0.05). Further analysis showed that patients with peak blood glucose ≥14.0 mmol/L had a higher risk of postoperative complications (χ²=8.246, P=0.004) and a higher incidence of grade III complications (χ²=5.262, P=0.022). Among patients with SHG, the incidence of postoperative complications differed significantly among groups with different SHG durations (χ²=25.862, P<0.001). Conclusion Early postoperative SHG is an independent risk factor for postoperative complications in gastric cancer patients without a history of type 2 diabetes mellitus. Severe hyperglycemia and prolonged SHG duration are associated with an increased risk of complications. Therefore, perioperative blood glucose management should focus on both glucose level and duration.

Key words

gastric cancer / stress hyperglycemia / postoperative complications / type 2 diabetic

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CHENG Yi-fan , TIAN Zhen , ZHOU Jia-jie , et al . The impact of early postoperative stress hyperglycemia on postoperative complications in non-type 2 diabetic patients with gastric cancer[J]. Chinese Journal of Practical Surgery. 2026, 46(4): 516-521 https://doi.org/10.19538/j.cjps.issn1005-2208.2026.04.22

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