术前营养状况对结直肠癌切除术手术部位感染的影响。

Effect of Preoperative Nutritional Status on Surgical Site Infection in Colorectal Cancer Resection.

作者信息

Tanaka Toshimichi, Sato Takeo, Yamashita Keishi, Hosoda Kei, Nakamura Takatoshi, Watanabe Masahiko

机构信息

Department of Surgery, Kitasato University School of Medicine, Minami-ku, Sagamihara, Japan.

出版信息

Dig Surg. 2017;34(1):68-77. doi: 10.1159/000448123. Epub 2016 Jul 28.

DOI:10.1159/000448123

PMID:27463391

Abstract

BACKGROUND/AIMS: Postoperative complications of colorectal cancer (CRC) can sometimes be life threatening. Prevention of morbidity is therefore the most important issue, and among such complications, surgical site infections (SSIs) are the most critical. Predictive factors for SSI were evaluated.

PATIENTS AND METHODS

This was a retrospective study of 432 patients with CRC. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs).

RESULTS

Preoperative serum albumin (relative risk (RR) 2.51, p = 0.01) and body mass index (BMI: RR 2.36, p = 0.02) were the independent risk factors for iSSIs, while rectal cancer (RR 6.34, p < 0.0001), preoperative serum albumin (RR 7.03, p = 0.004), age (RR 2.71, p = 0.02), and male sex (RR 2.41, p = 0.05) were the independent risk factors for o/sSSIs. Patients with both low serum albumin and high BMI had the highest incidence of iSSIs (34.2%), and the group with rectal cancer and low serum albumin had the highest incidence of o/sSSIs (57.1%).

CONCLUSIONS

Preoperative nutritional status is a risk factor for SSIs in CRC, and its proper preoperative management may reduce the risk of SSIs.

摘要

背景/目的：结直肠癌（CRC）术后并发症有时会危及生命。因此，预防发病是最重要的问题，在这些并发症中，手术部位感染（SSI）最为关键。对SSI的预测因素进行了评估。

患者与方法

这是一项对432例CRC患者的回顾性研究。SSI分为切口SSI（iSSI）和器官/腔隙SSI（o/sSSI）。

结果

术前血清白蛋白（相对危险度（RR）2.51，p = 0.01）和体重指数（BMI：RR 2.36，p = 0.02）是iSSI的独立危险因素，而直肠癌（RR 6.34，p < 0.0001）、术前血清白蛋白（RR 7.03，p = 0.004）、年龄（RR 2.71，p = 0.02）和男性（RR 2.41，p = 0.05）是o/sSSI的独立危险因素。血清白蛋白低且BMI高的患者iSSI发生率最高（34.2%），直肠癌且血清白蛋白低的组o/sSSI发生率最高（57.1%）。