Risk Factors and Postoperative Morbidities in Colon Cancer Patients with Preoperative Hypoalbuminemia

手術前低血漿白蛋白的結腸癌患者之相關危險因子與併發症分析

謝孟樵(Meng-Chiao Hsieh) ； 靳志堅(Chih-Chien Chin) ； 黃文詩(Wen-Shih Huang) ； 葉重宏(Chung-Hung Yeh) ； 郭益宏(Yi-Hung Kuo) ； 陳進勛(Jinn-Shiun Chen) ； 王正儀(Jeng-Yi Wang)

《中華民國大腸直腸外科醫學會雜誌》 23卷1期 (2012/03) Pp. 6-12

https://doi.org/10.6312/SCRSTW.2012.23(1).10012

摘要

Purpose. The aims of this study were to identify the risk factors associated with preoperative hypoalbuminemia in colon cancer patients and to retrospectively determine the relationship between the preoperative hypoalbuminemia and postoperative morbidities of curative colon surgery. Methods. This study included 2048 consecutive patients who underwent curative surgery for colon cancer between January 1994 and December 2005. These patients were categorized into 2 groups, hypoalbuminemia group (serum albumin level less than 3.5 g/dL) and normal albumin level group. We analyzed clinicopathologic variables, medical illnesses, and postoperative morbidities in these patients. Results. Three hundred and ninety five patients (19.3%) had preoperative hypoalbuminemia and 1653 patients had normal albumin level. Preoperative hypoalbuminemia was associated with old age (24.8% vs. 13.1%), right-sided colon cancer (48.1% vs. 36.1%), emergent operation (4.6% vs. 1.1%), poor tumor differentiation (19.8% vs. 13.5%), high preoperative carcinoembryonic antigen levels (46.0% vs. 33.7%), previous cerebrovascular accident (5.8% vs. 3.3%), diabetes mellitus (17.7% vs. 10.7%), and liver cirrhosis (3.3% vs. 0.8%). We identified preoperative hypoalbuminemia as an independent risk factor for postoperative morbidities of wound infection, wound dehiscence (4.6% vs. 1.9%), pneumonia (2.3% vs. 0.1%), bladder dysfunction (5.6% vs. 1.2%), and surgical anastomotic leakage/anastomotic stenosis (1.8% vs. 0.7%). All the abovementioned associations were statistically significant (p ＜ 0.05). Conclusion. Preoperative hypoalbuminemia is an independent predictor of high postoperative morbidity in colon cancer patients. Further longterm follow-up studies are required for analyzing the long-term outcomes of preoperative hypoalbuminemia.

關鍵字

結腸腫瘤 ； 低血漿白蛋白 ； 營養不良 ； 併發症

並列摘要

Purpose. The aims of this study were to identify the risk factors associated with preoperative hypoalbuminemia in colon cancer patients and to retrospectively determine the relationship between the preoperative hypoalbuminemia and postoperative morbidities of curative colon surgery. Methods. This study included 2048 consecutive patients who underwent curative surgery for colon cancer between January 1994 and December 2005. These patients were categorized into 2 groups, hypoalbuminemia group (serum albumin level less than 3.5 g/dL) and normal albumin level group. We analyzed clinicopathologic variables, medical illnesses, and postoperative morbidities in these patients. Results. Three hundred and ninety five patients (19.3%) had preoperative hypoalbuminemia and 1653 patients had normal albumin level. Preoperative hypoalbuminemia was associated with old age (24.8% vs. 13.1%), right-sided colon cancer (48.1% vs. 36.1%), emergent operation (4.6% vs. 1.1%), poor tumor differentiation (19.8% vs. 13.5%), high preoperative carcinoembryonic antigen levels (46.0% vs. 33.7%), previous cerebrovascular accident (5.8% vs. 3.3%), diabetes mellitus (17.7% vs. 10.7%), and liver cirrhosis (3.3% vs. 0.8%). We identified preoperative hypoalbuminemia as an independent risk factor for postoperative morbidities of wound infection, wound dehiscence (4.6% vs. 1.9%), pneumonia (2.3% vs. 0.1%), bladder dysfunction (5.6% vs. 1.2%), and surgical anastomotic leakage/anastomotic stenosis (1.8% vs. 0.7%). All the abovementioned associations were statistically significant (p ＜ 0.05). Conclusion. Preoperative hypoalbuminemia is an independent predictor of high postoperative morbidity in colon cancer patients. Further longterm follow-up studies are required for analyzing the long-term outcomes of preoperative hypoalbuminemia.

並列關鍵字

Colon cancer ； Hypoalbuminemia ； Malnutrition ； Morbidity