Department of Anesthesia, Institut de Cancerologie Gustave Roussy, 94080 Paris, France.
Department of Anesthesia and Intensive Care, APHP Hopital Pitié Salpétrière, 75013 Paris, France.
Int J Environ Res Public Health. 2022 Mar 14;19(6):3394. doi: 10.3390/ijerph19063394.
Hypoalbuminemia in major cancer surgery can lead to postoperative short and long-term complications. Our study was designed to detect albumin variations in three major cancer surgeries: ovarian debulking (DBK), major abdominal gastrointestinal surgery (ABD), and major cervico-facial, or ear, nose and throat cancer surgery (ENT). Single-center prospective study inclusion criteria were non-emergency procedures scheduled to last at least five hours. We performed hourly perioperative monitoring of the patients’ albuminemia and hemoglobinemia. Electronic charts were followed for at least five years for survival analysis. Sixty-three patients were analyzed: 30 in the DBK group, 13 in the ABD group, and 20 in the ENT group. There was a significant difference in albumin decrease between the ENT group and the two others (−19% at six hours in the ENT group versus -49% in the debulking group and −31% in the ABD group (p < 0.05). There was no significant difference between the DBK and ABD groups. The decrease in hemoglobin was not significantly different between the groups, and no significant difference was observed in long-term survival. DBK and ABD surgery yielded significant hypoalbuminemia. Therefore, the extent of decrease in serum albumin is probably not the only etiology of the specific postoperative complications of these major surgeries. No significant difference was noticed in five-year mortality, and no correlation was found in relation to the degree of intraoperative albumin kinetics.
重大癌症手术后的低白蛋白血症可导致术后短期和长期并发症。我们的研究旨在检测三种主要癌症手术中的白蛋白变化:卵巢去势术(DBK)、大腹部胃肠手术(ABD)和大颈面部或耳、鼻、喉癌手术(ENT)。单中心前瞻性研究的纳入标准是计划持续至少五小时的非紧急手术。我们对患者的白蛋白血症和血红蛋白血症进行了每小时的围手术期监测。电子图表至少随访五年以进行生存分析。对 63 名患者进行了分析:DBK 组 30 名,ABD 组 13 名,ENT 组 20 名。ENT 组与另外两组相比,白蛋白下降有显著差异(ENT 组六小时白蛋白下降 19%,而去势组下降 49%,ABD 组下降 31%(p<0.05)。DBK 和 ABD 两组之间无显著差异。各组间血红蛋白下降无显著差异,长期生存率无显著差异。DBK 和 ABD 手术导致明显的低白蛋白血症。因此,血清白蛋白的下降程度可能不是这些重大手术特定术后并发症的唯一病因。五年死亡率无显著差异,与术中白蛋白动力学程度之间也未发现相关性。