Department of Surgery, Tokyo General Hospital, Tokyo, Japan.
Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Surg Today. 2023 Jul;53(7):816-823. doi: 10.1007/s00595-022-02625-1. Epub 2022 Nov 28.
Cholinesterase is a nutritional marker associated with sarcopenia. The present study evaluated the relationship between cholinesterase and postoperative infectious complications in patients undergoing colorectal resection for colorectal cancer.
The study involved 231 patients who had undergone colorectal resection for colorectal cancer. We retrospectively investigated the relationship between preoperative serum cholinesterase levels and postoperative infectious complications. Univariate and multivariate analyses were performed to identify independent risk factors for postoperative infectious complications. We then performed stratified analyses to assess the interaction between cholinesterase and clinical variables to predict postoperative infectious complications.
In the multivariate analysis, the body mass index (P = 0.010), serum cholinesterase levels (P = 0.005), sarcopenia (P = 0.003) and blood loss (P < 0.001) were independent risk factors for postoperative infectious complications. In stratified analyses, the association between serum cholinesterase levels and postoperative infectious complications differed by the sarcopenia status (P = 0.006).
Preoperative serum cholinesterase levels may be useful for predicting postoperative infectious complications in colorectal cancer surgery. The association differs by the sarcopenia status, suggesting a potential interaction between nutritional markers and sarcopenia.
胆碱酯酶是与肌肉减少症相关的营养标志物。本研究评估了接受结直肠切除术治疗结直肠癌的患者胆碱酯酶与术后感染性并发症之间的关系。
本研究纳入了 231 例接受结直肠切除术治疗结直肠癌的患者。我们回顾性调查了术前血清胆碱酯酶水平与术后感染性并发症之间的关系。进行单因素和多因素分析，以确定术后感染性并发症的独立危险因素。然后进行分层分析，以评估胆碱酯酶与临床变量之间的交互作用，预测术后感染性并发症。
在多因素分析中，体质指数（P=0.010）、血清胆碱酯酶水平（P=0.005）、肌肉减少症（P=0.003）和出血量（P<0.001）是术后感染性并发症的独立危险因素。在分层分析中，血清胆碱酯酶水平与术后感染性并发症之间的关系因肌肉减少症状态而异（P=0.006）。
术前血清胆碱酯酶水平可能有助于预测结直肠癌手术的术后感染性并发症。这种关联因肌肉减少症状态而异，提示营养标志物与肌肉减少症之间可能存在相互作用。
