Pre-operative albumin level is associated with length of hospital stay in patients undergoing colorectal cancer surgery

Abstract Background Gastrointestinal dysfunction is a common and major complication after colorectal cancer surgery that results in significant psychological disturbance and economic burden. Although some studies have shown the potential therapeutic effect of acupuncture on gastrointestinal motility recovery, there is still a lack of high-quality evidence. Methods The trial is designed as a multicentre, parallel-group, randomized, single-blinded (outcome assessors), superiority, randomized trial. A total of 160 eligible patients will be randomly assigned to two groups: the electro-acupuncture (EA) group and the routine treatment (RT) group. Patients in the EA group will receive EA combined with routine treatment. EA will be administered for 30 minutes, once a day, starting 24 hours after surgery and lasting for 3 days. Patients in the RT group will receive routine intervention lasting until the patients are discharged from the hospital. The primary outcome will be the time to first flatus. The secondary outcomes will include the time to first defecation, visual analogue scale (VAS) scores for postoperative incision pain or abdominal pain, quality of recovery-40 (QOR-40) scores and the length of hospital stay. These outcomes will be evaluated at 24 h as well as on the 2nd and 3rd days after surgery. Any side effects of the treatment will be observed and recorded. Discussion We expect that the study results will provide high-level evidence to determine the effects of EA on gastrointestinal motility recovery after colorectal cancer surgery.

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Psoas Muscle Index Defined by Computer Tomography Predicts the Presence of Postoperative Complications in Colorectal Cancer Surgery

Medicina ◽

10.3390/medicina57050472 ◽

2021 ◽

Vol 57 (5) ◽

pp. 472

Author(s):

Zalán Benedek ◽

Szabolcs Todor-Boér ◽

Loránd Kocsis ◽

Orsolya Bauer ◽

Nicolae Suciu ◽

...

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

Psoas Muscle ◽

Albumin Level ◽

Cancer Surgery ◽

High Grade ◽

C Reactive Protein ◽

Muscle Area ◽

Colorectal Cancer Surgery ◽

Reactive Protein

Background and Objectives: Sarcopenia is a recognized prognostic factor for both complications and survival in cancer patients. This study aims to analyze the relationship between sarcopenia measured by psoas muscle index on computer tomography scans and the presence of postoperative complications in colorectal cancer surgery. Materials and Methods: In a prospective study we recorded data from 51 patients who underwent colorectal cancer surgery in the Mures County Clinical Hospital, Romania. Total psoas muscle area and psoas density were measured at the level of the third lumbal vertebra (L3) for further index calculation. We also evaluated the general characteristics and laboratory analyses to obtain more information about status of the patients. Short-term postoperative complications were scored according to the Clavien-Dindo classification. Results: The majority of the 51 patients were male (61%) and the median age was 65 years. More than half of the cancer was located in the rectum (56.9%), a quarter in the right colon (25.5%), the rest in the sigmoid (11.8%), and the left colon (5.9%). Twenty-one patients (41.2%) developed a complication, five (9.8%) of these were Clavien-Dindo grade 3, 4 or 5 (high grade) and sixteen (31.3%) grade 1 or 2 (low grade). The low- and high-grade groups showed a significantly lower right psoas muscle area, left psoas muscle area, total psoas muscle area, and psoas muscle index (p < 0.001 in all cases). Among laboratory analyses, a significantly lower perioperative hematocrit, hemoglobin, and albumin level were found in patients who developed complications. Furthermore we observed that an elevated serum C-reactive protein level was associated with a higher grade of complication (p < 0.043). Conclusions: The psoas muscle index (PMI) influence on the postoperative outcome is an important factor in our single center prospective study and it appears to be a good overall predictor in colorectal surgery. A lower PMI is directly associated with a low or high grade complication by Clavien-Dindo classification. Perioperative inflammatory and nutritional status evidenced by serum C-reactive protein (CRP) and albumin level influences the presence of postoperative complications.

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