Herlo Lucian Flavius, Golu Ioana, Herlo Alexandra, Virzob Claudia Raluca Balasa, Alin Ionescu, Iurciuc Stela, Iordache Ionut Eduard, Alexandrescu Luana, Tofolean Doina Ecaterina, Dumache Raluca
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Department of Internal Medicine II, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Diseases. 2025 Jan 15;13(1):16. doi: 10.3390/diseases13010016.
Colorectal cancer is a major contributor to global cancer morbidity and mortality. Surgical resection remains the cornerstone of treatment, but postoperative complications can significantly affect patient outcomes. Identifying factors that influence postoperative morbidity and mortality is crucial for optimizing patient care. This study aims to evaluate the impact of preoperative, intraoperative, and postoperative factors on surgical outcomes in patients with colorectal cancer.
A retrospective cohort study was conducted on 688 patients who underwent colorectal cancer surgery within a 10-year period. Data collected included demographic information, comorbidities, laboratory values, surgical details, and postoperative outcomes. Statistical analyses were performed using chi-square tests for categorical variables and t-tests for continuous variables. Multivariate logistic regression was used to identify independent predictors of postoperative complications and mortality.
Postoperative complications occurred in 28.5% of patients, and the 30-day mortality rate was 5.2%. Preoperative factors such as elevated C-reactive protein (CRP) levels ( < 0.001), low albumin levels ( = 0.003), a high American Society of Anesthesiologists (ASA) score ( < 0.001), and presence of comorbidities like diabetes and hypertension ( = 0.005) were significantly associated with increased postoperative complications. Intraoperative factors such as blood loss greater than 500 mL ( < 0.001) and longer operative time ( = 0.021) were also significant predictors of adverse outcomes. Multivariate analysis identified elevated CRP (OR 2.1, 95% CI 1.5-2.9), low albumin (OR 1.8, 95% CI 1.3-2.5), and blood loss > 500 mL (OR 2.4, 95% CI 1.7-3.4) as independent predictors of postoperative complications.
Preoperative inflammatory markers, nutritional status, ASA score, comorbidities, and intraoperative factors like blood loss significantly influence postoperative outcomes in colorectal cancer surgery. Recognizing these risk factors allows for better preoperative optimization and surgical planning, potentially reducing postoperative morbidity and mortality.
结直肠癌是全球癌症发病率和死亡率的主要贡献因素。手术切除仍然是治疗的基石，但术后并发症会显著影响患者的预后。识别影响术后发病率和死亡率的因素对于优化患者护理至关重要。本研究旨在评估术前、术中和术后因素对结直肠癌患者手术结局的影响。
对10年内接受结直肠癌手术的688例患者进行了一项回顾性队列研究。收集的数据包括人口统计学信息、合并症、实验室检查值、手术细节和术后结局。对分类变量采用卡方检验，对连续变量采用t检验进行统计分析。多因素逻辑回归用于识别术后并发症和死亡率的独立预测因素。
28.5%的患者发生了术后并发症，30天死亡率为5.2%。术前因素如C反应蛋白（CRP）水平升高（<0.001）、白蛋白水平低（=0.003）、美国麻醉医师协会（ASA）评分高（<0.001）以及存在糖尿病和高血压等合并症（=0.005）与术后并发症增加显著相关。术中因素如失血超过500 mL（<0.001）和手术时间延长（=0.021）也是不良结局的重要预测因素。多因素分析确定CRP升高（比值比2.1，95%置信区间1.5 - 2.9）、白蛋白低（比值比1.8，95%置信区间1.3 - 2.5）和失血>500 mL（比值比2.4，95%置信区间1.7 - 3.4）为术后并发症的独立预测因素。
术前炎症标志物、营养状况、ASA评分、合并症以及术中失血等因素显著影响结直肠癌手术的术后结局。认识到这些危险因素有助于更好地进行术前优化和手术规划，可能降低术后发病率和死亡率。
