Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, No. 123, Dapi Rd. Niaosong District, Kaohsiung City 83301, Taiwan.
Department of Information Management & College of Liberal Education, Shu-Te University, No. 59, Hengshan Rd., Yanchao, Kaohsiung City 82445, Taiwan.
Biomed Res Int. 2020 Aug 4;2020:2716395. doi: 10.1155/2020/2716395. eCollection 2020.
This study aimed at evaluating the impact of comorbid diabetes on short-term postoperative outcomes in patients with stage I/II colon cancer after open colectomy.
The data were extracted from the National Inpatient Sample database (2005-2010). Short-term surgical outcomes included in-hospital mortality, postoperative complications, and hospital length of stay.
A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in-hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in-hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in-hospital mortality than patients without any comorbidity.
The present results suggested the protective effects of uncomplicated diabetes on short-term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.
本研究旨在评估合并糖尿病对开腹结肠切除术治疗Ⅰ/Ⅱ期结肠癌患者短期术后结局的影响。
从国家住院患者样本数据库（2005-2010 年）中提取数据。短期手术结局包括院内死亡率、术后并发症和住院时间。
共纳入 49064 例接受开腹手术的Ⅰ/Ⅱ期结肠癌患者，平均年龄为 70.35 岁。其中 21.94%合并糖尿病。多变量分析显示，合并糖尿病与院内死亡率和术后并发症的风险降低显著相关。与无糖尿病的患者相比，单纯糖尿病患者的院内死亡率和术后并发症发生率较低，但合并复杂糖尿病的患者术后并发症发生率较高。此外，只有糖尿病患者，而不是糖尿病合并高血压患者，其院内死亡率低于无任何合并症的患者。
本研究结果提示，开腹结肠切除术后Ⅰ/Ⅱ期结肠癌患者中单纯糖尿病对短期手术结局具有保护作用。需要进一步的研究来证实这些意外发现，并探讨可能的潜在机制。
