Yano Yuki, Sagawa Masano, Yokomizo Hajime, Okayama Sachiyo, Yamada Yasufumi, Usui Takebumi, Yamaguchi Kentaro, Shiozawa Shunichi, Yoshimatsu Kazuhiko, Shimakawa Takeshi, Katsube Takao, Kato Hiroyuki, Naritaka Yoshihiko
Dept. of Surgery, Tokyo Women's Medical University Medical Center East.
Gan To Kagaku Ryoho. 2017 Oct;44(10):903-905.
Paitients and methods: We retrospectively reviewed a database of 188 patients who underwent resection for colorectal cancer with laparoscopic surgery between July 2007 and March 2015. The prognostic nutrition index(PNI), modified Glas- gow prognostic score(mGPS), controlling nutritional status(CONUT), and neutrophil/lymphocyte ratio(N/L)were measured in these patients. We examined the association between postoperative complications and clinicopathological factors.
The study included 110 men and 78 women. Median age was 68 years. The site of the primary lesion was colon in 118 and rectum in 70 patients. Postoperative complications higher than Grade II(Clavien-Dindo classification)were reported in 24(12.8%)patients: Surgical site infection(SSI)in 12, remote infection in 7, ileus in 5, and others in 2 patients. Clinicopathological factors related to complications were rectal surgery, large amount of intraoperative bleeding, and long operative time. The related immunologic and nutritional factors were mGPS 2, PNI below 40, and N/L above 3. CONUT was not associated with complications in ourcases.
mGPS, PNI, and N/L are predictive factors for complications in laparoscopic colorectal surgery.
患者与方法：我们回顾性分析了2007年7月至2015年3月期间188例行腹腔镜手术切除结直肠癌患者的数据库。对这些患者测量了预后营养指数（PNI）、改良格拉斯哥预后评分（mGPS）、控制营养状况（CONUT）和中性粒细胞/淋巴细胞比值（N/L）。我们研究了术后并发症与临床病理因素之间的关联。
该研究纳入110名男性和78名女性。中位年龄为68岁。原发灶位于结肠的有118例，位于直肠的有70例。24例（12.8%）患者报告了高于Ⅱ级（Clavien-Dindo分类）的术后并发症：手术部位感染（SSI）12例，远处感染7例，肠梗阻5例，其他2例。与并发症相关的临床病理因素为直肠手术、术中大量出血和手术时间长。相关的免疫和营养因素为mGPS 2、PNI低于40以及N/L高于3。在我们的病例中，CONUT与并发症无关。
mGPS、PNI和N/L是腹腔镜结直肠癌手术并发症的预测因素。
