Multivariate Regression Analysis of Postoperative Complications for Colon Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GAO Qiang ¹ , DOU Qianhui ¹ , FANG Chao ¹ , XIANG Qian ¹ , TANG Lin ¹ , WANG Xiaodong ² , LI Li ²

1.West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
2.Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Colon cancer; Operative risk; Postoperative complication; Multifactor analysis; Prognosis

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ObjectiveTo explore the risk factors influenced postoperative complications of colon cancer. MethodsIn this study, 114 patients diagnosed definitely as colon cancer were enrolled from January 2009 to April 2010 in this hospital. The patients were divided into the complication group and non-complication group according to the occurrence of postoperative complications during hospital day. Furthermore, clinicopathological features and operative parameters of patients were compared in two groups, and independent factors for postoperative complications were identified by multiple regression analysis. ResultsThere were statistical differences between two groups in operation time (t=2.034, P=0.032), diabetes mellitus (χ2=5.920, P=0.015), differentiation degree of tumor (χ2=7.163, P=0.028), hospital stay (χ2=0.411, P=0.026), and ASA grades (χ2=11.585, P=0.009). The morbidity of patients with operative time gt;200 min was significant higher than that ≤100 min (χ2=8.884, P=0.003) and 100-200 min (χ2=7.318, P=0.007). The morbidity of patients with ASA Ⅳ grade was higher than that with ASA Ⅰ grade (χ2=13.426, P=0.000). For tumor differentiation, the morbidity of patients with well-differentiated tumor was higher than that with moderately differentiated tumor (χ2=4.950, P=0.026) and poorly differentiated tumor (χ2=7.476, P=0.006). The hospital stay (P=0.009), age (P=0.024), diabetes mellitus (P=0.018), and ASA grade (P=0.001) were the independent factors for postoperative complications by multivariate regression analysis. ConclusionThe physical quality indexes are the mostly common risk factors of postoperative complications for colon cancer, emphasizing on the high-risk factors and making a targeted and individual treatment plan for each patient are of great important to improve the prognosis.

Citation： GAO Qiang ,DOU Qianhui,FANG Chao,XIANG Qian,TANG Lin,WANG Xiaodong,LI Li. Multivariate Regression Analysis of Postoperative Complications for Colon Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 159-163. doi: Copy

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1. Evans MD, Escofet X, Karandikar SS, et al. Outcomes of resection and nonresection strategies in management of patients with advanced colorectal cancer [J]. World J Surg Oncol, 2009, 7: 28.
2. 杨祖立, 汪建平, 王磊, 等. 结直肠癌预后的多因素回归分析 [J]. 中德临床肿瘤学杂志, 2003, 2(3): 149152.
3. Haga Y, Wada Y, Takeuchi H, et al. Estimation of surgical costs using a prediction scoring system: estimation of physiologic ability and surgical stress [J]. Arch Surg, 2002, 137(4): 481485.
4. 吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [J]. 中国普外基础与临床杂志, 2007, 14(6): 713715.
5. Greene FL, Stewart AK, Norton HJ. A new TNM staging strategy for nodepositive (stage Ⅲ) colon cancer: an analysis of 50 042 patients [J]. Ann Surg, 2002, 236(4): 416421.
6. 汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [J]. 中国普外基础与临床杂志, 2007, 14(6): 709712.
7. Russell SD, Saval MA, Robbins JL, et al. New York Heart Association functional class predicts exercise parameters in the current era [J]. Am Heart J, 2009, 158(4 Suppl): S24S30.
8. Loni瘙塅 D. Pulmonary function tests in bronchial asthma [J]. Pneumologia, 2008, 57(2): 7074.
9. Martenson JA, Lipsitz SR, Lefkopoulou M, et al. Results of combined modality therapy for patients with anal cancer (E7283). An Eastern Cooperative Oncology Group study [J]. Cancer, 1995, 76(10): 17311736.
10. Luna A, Rebasa P, Navarro S, et al. An evaluation of morbidity and mortality in oncologic gastric surgery with the application of POSSUM, PPOSSUM, and OPOSSUM [J]. World J Surg, 2009, 33(9): 18891894.
11. Paulson EC, Mahmoud NN, Wirtalla C, et al. Acuity and survival in colon cancer surgery [J]. Dis Colon Rectum, 2010, 53(4): 385392.
12. GarcíaGranero E. Assessment of the quality of bowel cancer surgery: “from the mesorectum to the mesocolon” [J]. Cir Esp, 2010, 87(3): 131132.
13. Telem DA, Chin EH, Nguyen SQ, et al. Risk factors for anastomotic leak following colorectal surgery: a casecontrol study [J]. Arch Surg, 2010, 145(4): 371376.
14. Polednak AP. Comorbid diabetes mellitus and risk of death after diagnosis of colorectal cancer: a populationbased study [J]. Cancer Detect Prev, 2006, 30(5): 466472.
15. 敖亚洲, 李稳霞, 崔亮, 等. 大肠癌并发糖尿病的临床分析 [J]. 河北医学, 2009, 15(2): 196198.
16. Truong S, Conze J, Willis S, et al. Palliative therapy of inoperable malignant occlusive jaundicestent implantation or biliodigestive anastomosis [J]. Langenbecks Arch Chir Suppl Kongressbd, 1996, 113: 762766.
17. Lim SB, Choi HS, Jeong SY, et al. Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer: an analysis of 570 consecutive cases [J]. Surg Endosc, 2008, 22(12): 25882595.
18. Krzyzanowska MK, Regan MM, Powell M, et al. Impact of patient age and comorbidity on surgeon versus oncologist preferences for adjuvant chemotherapy for stage Ⅲ colon cancer [J]. J Am Coll Surg, 2009, 208(2): 202209.
19. Tartter PI. Postoperative stay associated with prognosis of patients with colorectal cancer [J]. Ann Surg, 1996, 223(4): 351356.
20. 汪晓东, 谢尧, 肖军, 等. 快速流程在结直肠外科手术后管理中的应用 [J]. 中国普通外科杂志, 2008, 17(4): 394396.
21. Alberts SR. Neoadjuvant and adjuvant therapy combined with resection of hepatic colorectal cancer metastases [J]. Current Colorectal Cancer Reports, 2006, 2(2): 8184.
22. Marks JH, Valsdottir EB, DeNittis A, et al. Transanal endoscopic microsurgery for the treatment of rectal cancer: comparison of wound complication rates with and without neoadjuvant radiation therapy [J]. Surg Endosc, 2009, 23(5): 10811087.
23. Parikh AA, Gentner B, Wu TT, et al. Perioperative complications in patients undergoing major liver resection with or without neoadjuvant chemotherapy [J]. J Gastrointest Surg, 2003, 7(8): 10821088.
24. Biscione FM, Couto RC, Pedrosa TM, et al. Factors influencing the risk of surgical site infection following diagnostic exploration of the abdominal cavity [J]. J Infect, 2007, 55(4): 317323.
25. Sotnikov DN, Abraamian BA, Kurilov VP. Postoperative pyoinflammatory complications in patients with colostomy for large intestinal obstruction caused by colonic neoplasms [J]. Khirurgiia (Mosk), 2009, (6): 4449.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Multivariate Regression Analysis of Postoperative Complications for Colon Cancer

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