Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
Neoplasma. 2020 Jul;67(4):922-932. doi: 10.4149/neo_2020_190908N882. Epub 2020 May 6.
With the increasing number of elderly patients, the risk of diseases such as colorectal cancer (CRC) has increased. The objective of this prospective study was to explore the effects of sarcopenia, hypoalbuminemia, and laparoscopic surgery on postoperative complications among elderly patients who recently underwent colorectal surgery. Patients aged over 65 years who underwent surgery for CRC at the First Affiliated Hospital of Wenzhou Medical University were considered for this study. The demographical and clinical characteristics of these patients, as well as postoperative complications, were prospectively analyzed. The patients were divided into two groups depending on the diagnosis of sarcopenia, and the clinical variables corresponding to the two groups were compared. Further, the risk factors associated with postoperative complications were evaluated using univariate analysis and multivariate logistic regression analysis. A total of 360 patients fulfilled the inclusion criteria. Incidences of postoperative complications in the sarcopenia and non-sarcopenia groups were at 38.3% and 27.3%, respectively. In addition, sarcopenia (p=0.029) and hypoalbuminemia (p=0.010) were identified as independent risk factors, while laparoscopic surgery (p=0.023) was identified as a protective factor for postoperative complications. However, laparoscopic surgery was a protective factor for postoperative complications in the colon group only (p=0.001). Sarcopenia and hypoalbuminemia are independent risk factors that influence the probability of developing complications following CRC surgery. Laparoscopic surgery is a protective factor for postoperative complications of CRC patients, particularly colon cancer patients.
随着老年患者人数的增加,结直肠癌(CRC)等疾病的风险也有所增加。本前瞻性研究的目的是探讨骨骼肌减少症、低白蛋白血症和腹腔镜手术对近期接受结直肠手术的老年患者术后并发症的影响。本研究考虑了在温州医科大学第一附属医院接受 CRC 手术的年龄在 65 岁以上的患者。前瞻性分析了这些患者的人口统计学和临床特征以及术后并发症。根据骨骼肌减少症的诊断将患者分为两组,并比较两组对应的临床变量。此外,使用单因素分析和多因素逻辑回归分析评估与术后并发症相关的危险因素。共有 360 名患者符合纳入标准。骨骼肌减少症组和非骨骼肌减少症组的术后并发症发生率分别为 38.3%和 27.3%。此外,骨骼肌减少症(p=0.029)和低白蛋白血症(p=0.010)被确定为独立危险因素,而腹腔镜手术(p=0.023)被确定为术后并发症的保护因素。然而,腹腔镜手术仅对结肠癌组(p=0.001)是术后并发症的保护因素。骨骼肌减少症和低白蛋白血症是影响 CRC 手术后并发症发生概率的独立危险因素。腹腔镜手术是 CRC 患者,特别是结肠癌患者术后并发症的保护因素。