Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients  

作　　者：Paerhati Shayimu Maitisaidi Awula Chang-Yong Wang Rexida Jiapaer Yi-Peng Pan Zhi-Min Wu Yi Chen Ze-Liang Zhao 

机构地区：[1]Department of Gastrointestinal Surgery,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China [2]Department of General Surgery,Yutian County People’s Hospital,Hotan 848499,Xinjiang Uygur Autonomous Region,China [3]Department of Ultrasound,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China [4]Department of Gastroenterology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310020,Zhejiang Province,China [5]Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Guizhou Medical University,Guiyang 550003,Guizhou Province,China [6]Department of Breast and Thyroid Surgery,The Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang Uygur Autonomous Region,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第10期3142-3154,共13页世界胃肠外科杂志（英文）

基　　金：Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2019D01C261.

摘　　要：BACKGROUND Anastomotic leakage(AL)is one of the severest complications after laparoscopic surgery for middle/low rectal cancer,significantly impacting patient outcomes.Identifying reliable predictive factors for AL remains a clinical challenge.Serum nutritional biomarkers have been implicated in surgical outcomes but are un-derexplored as predictive tools for AL in this setting.Our study hypothesizes that preoperative serum levels of prealbumin(PA),albumin(ALB),and transferrin(TRF),along with surgical factors,can accurately predict AL risk.AIM To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery.METHODS In the retrospective cohort study carried out at a tertiary cancer center,we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022.Preoperative serum levels of PA,ALB,and TRF were measured.We employed multivariate logistic regression to determine the independent risk factors for AL,and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis.RESULTS AL occurred in 11.96%of cases,affecting 67 out of 560 patients.Multivariate analysis identified PA,ALB,and TRF as the independent risk factor,each with an odds ratio of 2.621[95%confidence interval(CI):1.582-3.812,P=0.012],3.982(95%CI:1.927-4.887,P=0.024),and 2.109(95%CI:1.162-2.981,P=0.031),respectively.Tumor location(<7 cm from anal verge)and intraoperative bleeding≥300 mL also increased AL risk.The predictive model demonstrated an excellent accuracy,achieving an area under the receiver operating characteristic curve of 0.942,a sensitivity of 0.844,and a specificity of 0.922,demonstrating an excellent ability to discriminate.CONCLUSION Preoperative serum nutritional biomarkers,combined with surgical factors,reliably predict anastomotic leakage risk after rectal cancer surgery,highlighting their importance in preoperative assessment.

关 键 词：Rectal cancer Laparoscopic operation Anastomotic leakage ALBUMIN PREALBUMIN TRANSFERRIN 

分 类 号：R735.37[医药卫生—肿瘤]