Study On The Correlation Between Preoperative Nutrition Risk Screening Score And Anastomotic Leakage After Radical Resection Of Colon Cancer

Objective:Radical surgery combined with adjuvant chemotherapy is currently the main treatment for colon cancer,and anastomotic leakage is a common serious complication after colon cancer surgery.Most patients with colon cancer already have nutritional risks before surgery.It is generally believed that preoperative nutritional risk is related to the prognosis of colon cancer after surgery,but there is a lack of research on the correlation between preoperative nutritional risk and anastomotic leakage.To explore the relationship between preoperative nutritional risk and anastomotic fistula after radical resection of colon cancerMethods:From January 2014 to January 2020,the Second Affiliated Hospital of Kunming Medical University was diagnosed with colon cancer for the first time,undergoing radical resection of the tumor and completing one stage of digestive tract reconstruction,330 patients who met the inclusion exclusion criteria were selected as the study Object.Collect the clinical information of patients,and use NRS2002 to score patients before surgery from three aspects:age,nutritional damage status,and disease severity.NRS2002?3 is classified as having nutritional risk,and<3 is not classified as nutritional risk.The selected patients were divided into anastomotic leakage fistula group and anastomotic leakage fistula group.There were 38 cases in the anastomotic leakage group,including 7 cases with NRS2002<3 points and 31 cases with?3 points.There were 292 cases of anastomotic leakage fistula group,including NRS 2002<3 points 150 cases,?3 points 142 cases.Univariate and multivariate logistic regression analysis were performed on the two groups of patients Compare the factors related to the nutritional status of the two groups of patients(age?70 years,BMI value,preoperative hypoalbuminemia,diabetes,preoperative combined with incomplete intestinal obstruction,malnutrition,nutritional risk),non-nutrition related factors {gender,Relationship between hypertension,smoking,surgical method(opening/laparoscopy),tumor location(left semicolonectomy/right semicolonectomy),prophylactic stoma,TNM staging} and anastomotic leakage.Results:173 patients had NRS2002?3 points before surgery,accounting for 52.4%(173/330),and the incidence of anastomotic leakage was 17.9%(31/173).157 patients had NRS2002<3 points before operation,and the incidence of anastomotic leakage was 4.5%(7/157).Univariate analysis showed that the patients with anastomotic leakage group and non-anastomotic leakage group had preoperative NRS2002 score,age ? 70 years,preoperative hypoalbuminemia,diabetes,preoperative combined incomplete intestinal obstruction,tumor location,TNM staging The difference was statistically significant(P<0.05).There was no statistically significant difference in gender,preoperative malnutrition,hypertension,smoking,surgical methods,and preventive stoma(P>0.05).Multivariate logistic regression analysis showed:left hemicolectomy(OR=3.289,95%CI:1.380-7.834),diabetes(OR=2.778,95%CI:1.003-7.692),preoperative NRS2002?3 points(OR=4.970,95%CI:1.751-14.106)independently associated with the occurrence of anastomotic leakage after radical resection of colon cancer.Conclusion:1.Nutritional risk is associated with the occurrence of anastomotic leakage after colon cancer surgery.2.There are many nutritional risks in patients with colon cancer before operation.NRS 2002 score is an effective evaluation tool.Patients with nutritional risks should be given enough attention to ensure that adequate nutritional support during the perioperative period helps reduce the incidence of anastomotic leakage.