Correlation Of Preoperative Nutritional Status And Postoperative Complication

Background:Colorectal carcinoma is a common gastrointestinal malignancies.In recent years,cases of gradually increasing, and tend to elderly patients. In western developedcountries, colorectal carcinoma is the second malignancy second only to lung cancer.Different countries are60times the difference between the incidence. The predilectionsites is rectum, the junction of the rectum and sigmoid colon, accounted for60%.Theincidence is more in60-70years old, less and20%of the50-year-old.ESPEN launched hospitalized patients with Nutritional risk guide in2002,which isNRS2002.It has the basis of evidence-based medicine, Assessment of malnutritionhave varied in the past, but the lack of nutrition risk screening. The assessment ofnutritional risk is a reasonable basis of parenteral and enteral nutrition support.In clinical, the treatment of patients with colorectal carcinoma is mainly to surgery.Before admission, patients often exist malnutrition, which need nutritional supporttreatment.NRS2002simple, easy, non-invasive, and lower cost, nutritional risk andnutritional intervention for the first combined, proved a strong basis for preoperativescreening of nutritional status of cancer patients.NRS2002simple, easy, non-invasive, and lower cost, nutritional risk andnutritional intervention for the first combined, proved a strong basis for preoperativescreening of nutritional status of cancer patients.Objective:Relationship analysis of colorectal cancer patients with preoperative nutritionalscreening and postoperative complicationsMethods:217cases needing elective surgical treatment with colorectal carcinoma patients has been retrospective surveyed. Inclusion criteria:①Histopathological examinationhas been proven to be colorectal malignancy;②Before hospitalization they have notbeen all kinds of anti-cancer therapy, underwent radical surgical treatment afterhospitalization;③Clear consciousness, able to stand, no serious obstacle to majororgans.④Stable condition, capable of verbal communication;⑤Voluntary inclusionand in line with the study, and informed consent. Then grouped according to thenutrition ratings(A group: nutritional risk, group B: no nutritional risk). According toage, initial diagnosis, secondary diagnosis, preoperative BMI score, postoperativepathology, tumor differentiation, genotyping of specimens, the presence of mucinouscarcinoma or non-existent, postoperative tumor invasion, lymph node metastasis, distantmetastasis postoperative nutritional score, the BMI score after surgery, preoperative andpostoperative laboratory tests. And the type and quantity of the presence of the normaldischarge and postoperative complications have been recorded. Finally, respectively forstatistical analysis.Results:In the study of preoperative nutritional status, the age, secondary diagnosis,preoperative hemoglobin, preoperative albumin affect the nutritional risk group and nonutritional risk group. Age (P<0.001),Secondary diagnosis(P=0.044，P<0.05),Preoperative hemoglobin (P=0.003，P<0.05)，Preoperative albumin(P=0.02，P<0.05).In preoperative and postoperative laboratory testing indicators, hemoglobin,white blood cells, neutrophils, platelets, alanine aminotransferase, albumin, serumcreatinine, NRS score, BMI is statistically significant for the preoperative andpostoperative group,and affect the outcome of the surgery.In the study of the indicatorsand installments of preoperative and postoperative nutritional status and complications,more than70years old, male, BMI greater than25,preoperative secondary diagnosisof primary tumor with diabetes,N2stage,M1stage, Dukes D，preoperative hemoglobinmale<120/female <110,preoperative albumin<35g/L is a higher probability for theother group of complications. Age（P=0.015），Gender（P=0.004），BMI（P=0.023），Preoperative secondary diagnosis（P<0.001），N stage（P=0.003），M stage（P<0.001），Postoperative Dukes stage （P<0.001）， Preoperative hemoglobin （P=0.002），Preoperative albumin(P=0.006).In this research, the incidence of complications(24%) ofthe group of preoperative NRS2002score≥3is higher than incidence ofcomplications(4.5%) of the score<3（P=0.036，P<0.05）. Conclusion:NRS2002scoring method is suitable for the nutrition risk assessment of patientswith colorectal carcinoma in China. Preoperative NRS2002≥3of the patients ofcolorectal carcinoma is more susceptible to complications.This result suggests that the patients of preoperative NRS2002≥3need to bestrengthened.