| Objective Under enhanced recory after surgery(ERAS)concept,to explore the predictive value of serum C reactive protein to albumin ratio(CAR)in patients underwent laparoscopic radical resection of colorectal cancer on complications in 30 days after operation.Methods The continuous collection of 220 patients with primary colorectal carcinoma(CRC)underwent laparoscopic radical resection of colorectal cancer under ERAS concept from January 2018 to June 2020 in the gastrointestinal surgery department of Taizhou People’s hospital.The basic data,intraoperative data and laboratory data of patients were obtained from the hospital database for analysis.The postoperative complications were followed up to 30 days after operation.According to the occurrence of postoperative complications,we had divided the patients into two groups,and used statistical methods to analyze the basic clinical and laboratory data of them,the significantly statistical related factors were obtained.By drawing the ROC curve of each influencing factor,the predictive sensitivity and the predictive specificity were obtained to evaluate the predictive value of short-term postoperative complications of CRC patients,these influencing factors were included in the binary Logistic multivariate regression analysis to further find out the independent influencing factors.Finally,all the cases were divided into two groups with the cut-off value of the independent influencing factors.Between the two groups,the short-term complications of them were further to compare.Results Final inclusion of 200 valid cases,the complications occurred in 55 cases within30 days after operation,the proportion was 27.5%,Define postoperative complications by Clavien-Dindo,among them,45 cases of general complications(grade Ⅰ-Ⅱ),10 cases of severe complications(grade Ⅲ and above),there were no obvious postoperative complications in another 145 cases.The basic data of the patients,the laboratory data were obtained before operation,on the first day after operation and on third day after operation were examined by statistical methods,the age,hypertension,diabetes,the length of operation,the intraoperative blood loss,the serum CRP level on the first day after operation,the serum Alb level on the third day after operation,the serum CRP value on the third day after operation and the CAR on third day after operation had significant differences,their P values were all less than 0.05.Draw the ROC curve of the above factors,found that the CAR level on third day after operation had the largest area under the curve was 0.852,the sensitivity was 0.727,and specificity was 0.862,the youden index was 0.589.By the multivariate binary Logistic analysis,only the CAR level on third day after operation was different statistically(the P<0.001),and the cut off value is 1.49,all cases were divided into two groups,one was CAR≥1.49 on third day after operation,and another was CAR<1.49 on third day after operation,the results showed that the CAR on third day after operation was closely related to the occurrence of short-term postoperative complications(c~2 =36.055,P < 0.001),and it was more obvious to occur the postoperative abdominal distension(P=0.037)and the pulmonary infection(P=0.027).Conclusion1.For patients with minimally invasive colorectal cancer,and under the concept of ERAS in perioperative period,the CAR on the third day after operation can be used to predict the occurrence of short-term postoperative complications,the sensitivity is 0.727 and the specificity is 0.862.2.The CRC patients whose serum CAR≥1.49 on third day after operation were more likely to arise short-term postoperative complications(52.8% vs 13.3%)than those CAR < 1.49,the abdominal distension(9.7% vs 2.3%)and the pulmonary infection(8.3% vs 1.6%)were more likely to arise. |
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