Lohsiriwat Varut, Chinswangwatanakul Vitoon, Lohsiriwat Supatra, Akaraviputh Thawatchai, Boonnuch Wiroon, Methasade Asada, Lohsiriwat Darin
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Prannok Rd, Bangkoknoi, Bangkok 10700, Thailand.
Asia Pac J Clin Nutr. 2007;16(2):213-7.
To determine the relationship between preoperative serum albumin and postoperative bowel function as well as surgical outcomes in right-sided colon cancer patients.
This retrospective study in a university hospital included 84 patients who underwent elective right hemicolectomy for adenocarcinoma of the right-sided colon between January 2004 and December 2005. The patients had a preoperative serum albumin assessment. Serum albumin less than 3.5 g/dL was regarded as hypoalbuminemia. Postoperative outcomes were classified into mortality, morbidity (infectious and noninfectious complications), time to first bowel movement, time to resume normal diet, and hospital stay.
Forty males (48%) and forty-four females (52%) with a mean age of 64 (range, 27-89) years were included. Forty-eight patients (57%) had hypoalbuminemia. No 30-day postoperative mortality occurred. All 14 postoperative complications occurred in hypoalbuminemic cases. Therefore, 29% of the hypoalbuminemics had complications whereas none occurred in nonhypoalbuminemics (p=0.001). In univariate analysis, hypoalbuminemia and postoperative complications were the risk factors for delayed postoperative recovery of bowel function and prolonged length of hospital stay. In multivariate analysis, hypoalbuminemia was the significant risk factor for postoperative complications (p<0.001) and delayed time to first bowel movement (p=0.018) whereas postoperative complications were the significant risk factor for delayed time to resume normal diet (p<0.001) and prolonged hospital stay (p<0.001).
Hypoalbuminemia is a potential predictor of delayed recovery of bowel function postoperatively and significantly associated with postoperative complications in right-sided colon cancer patients undergone right hemicolectomy.
确定右侧结肠癌患者术前血清白蛋白与术后肠功能以及手术结局之间的关系。
这项在大学医院开展的回顾性研究纳入了2004年1月至2005年12月期间因右侧结肠癌腺癌接受择期右半结肠切除术的84例患者。对患者进行了术前血清白蛋白评估。血清白蛋白低于3.5 g/dL被视为低白蛋白血症。术后结局分为死亡率、发病率（感染性和非感染性并发症）、首次排便时间、恢复正常饮食时间和住院时间。
纳入40例男性（48%）和44例女性（52%），平均年龄64岁（范围27 - 89岁）。48例患者（57%）存在低白蛋白血症。术后30天内无死亡病例。所有14例术后并发症均发生在低白蛋白血症患者中。因此，29%的低白蛋白血症患者出现并发症，而非低白蛋白血症患者无一例发生并发症（p = 0.001）。在单因素分析中，低白蛋白血症和术后并发症是术后肠功能恢复延迟和住院时间延长的危险因素。在多因素分析中，低白蛋白血症是术后并发症（p < 0.001）和首次排便时间延迟（p = 0.018）的显著危险因素，而术后并发症是恢复正常饮食时间延迟（p < 0.001）和住院时间延长（p < 0.001）的显著危险因素。
低白蛋白血症是右侧结肠癌患者接受右半结肠切除术后肠功能恢复延迟的潜在预测指标，且与术后并发症显著相关。
