title: Postoperative hyperglycemia in nondiabetic patients after gastric surgery for cancer: perioperative outcomes.
abstract: BACKGROUND
  Hyperglycemia (HG) is widely known to be associated with increased postoperative complications after colorectal surgery. Very few data on the effects of HG on patients after gastric surgery for cancer are reported in literature. The aim of this study was to evaluate the effects of postoperative HG in non-diabetic patients undergoing gastrectomy for cancer.
  
  
  METHODS
  One hundred and ninety-three consecutive gastrectomies for cancer performed between January 2010 and December 2015 were considered. Diabetic patients, and those undergoing pancreatic resections were excluded. Postoperative blood glucose levels were monitored in the first 72 h after surgery. Postoperative complications, mortality, and postoperative course were analyzed in patients who experienced postoperative HG (blood glucose level; BGL > 125 mg/dl) compared with euglycemic patients (BGL ≤ 125 mg/dl). Differences between mild HG (BGL between 125 and 200 mg/dl) and severe HG (BGL ≥ 200 mg/dl) were also analyzed.
  
  
  RESULTS
  Ninety-six patients (55.5 %) experienced postoperative HG. In 11 patients (6.4 %), a severe postoperative HG was found. Postoperative BGL > 200 mg/dl was related to worse outcomes than those experienced by euglycemic patients (and even than patients who experienced mild postoperative HG). The postoperative complications rate was 24.8 % (43 patients out of 173), but significantly higher in patients with postoperative severe HG compared to mild HG and normoglycemic patients (63.6, 30.6, and 13 %, respectively, p < 0.001).
  
  
  CONCLUSIONS
  Poor postoperative glycemic control seems to be related to worse postoperative outcomes even in patients undergoing elective gastric surgery for cancer.
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy. claudio.fiorillo@hotmail.it.
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiorillo
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Rosa
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Quero
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Menghi
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Doglietto
authors.affiliation: Department of Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli 8, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Alfieri
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: Gastric cancer; Hyperglycemia; Perioperative complications