First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
Department of Radiology, Laikon General Hospital, Athens, Greece.
Nutr Cancer. 2022;74(8):2846-2858. doi: 10.1080/01635581.2022.2036769. Epub 2022 Feb 7.
Malnourished patients undergoing esophagectomy have increased risk of postoperative complications. The aim of the current study was to identify nutritional and functional risk factors for postoperative complications in patients with esophageal and gastroesophageal junction cancer who underwent esophagectomy. Seventy patients who were admitted at the First Department of Surgery, Laikon General Hospital, Athens, Greece, were included in this study. Laboratory data and data regarding nutritional and functional status were recorded preoperatively. Postoperative complications were graded according to Clavien-Dindo classification. Thirty-seven patients (52.9%) developed postoperative complications. Albumin and Geriatric Nutritional Risk Index (GNRI) levels were lower in patients who developed major complications compared to patients who did not develop postoperative complications (3.90 ± 0.44 vs 4.18 ± 0.37 g/dL, = 0.014 and 107.40 ± 15.76 vs 114.98 ± 12.26, = 0.050 respectively). Major complications were associated with higher percentage of weight loss (12.1 ± 11.1 vs 6.2 ± 7.5%, = 0.019) and with low handgrip strength (80 vs 16.9%, = 0.006). Albumin (3.93 ± 0.18 vs 4.15 ± 0.41 g/dL, = 0.019) and low muscle mass (22.6 vs 2.8%, = 0.016) were significantly associated with anastomotic leakage occurence. The incorporation of patients' nutritional and functional status in the preoperative risk assessment might increase prognostic ability concerning postoperative complications of patients undergoing esophagectomy.
营养不良的食管癌患者术后并发症风险增加。本研究旨在确定接受食管癌和胃食管交界处癌切除术的患者的营养和功能危险因素。本研究纳入了希腊雅典 Laikon 综合医院第一外科的 70 名患者。记录了术前的实验室数据以及营养和功能状况的数据。根据 Clavien-Dindo 分级系统对术后并发症进行分级。37 名患者（52.9%）发生了术后并发症。与未发生术后并发症的患者相比，发生严重并发症的患者的白蛋白和老年营养风险指数（GNRI）水平较低（3.90±0.44 与 4.18±0.37 g/dL， = 0.014 和 107.40±15.76 与 114.98±12.26， = 0.050 分别）。严重并发症与更高的体重减轻百分比（12.1±11.1 与 6.2±7.5%， = 0.019）和较低的握力（80 与 16.9%， = 0.006）相关。白蛋白（3.93±0.18 与 4.15±0.41 g/dL， = 0.019）和低肌肉量（22.6 与 2.8%， = 0.016）与吻合口漏的发生显著相关。将患者的营养和功能状况纳入术前风险评估中可能会提高对接受食管癌切除术患者术后并发症的预测能力。
