Factors associated with complications after radical surgery for colorectal cancer
10.3760/cma.j.cn341190-20240603-00676-1
- VernacularTitle:结直肠癌根治术后并发症发生的相关因素分析
- Author:
Feng ZHANG
1
;
Haotian WANG
1
;
Jian CHENG
1
Author Information
1. 西安航天总医院普通外科,西安 710100
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Colorectal surgery;
Factor analysis, statistical;
Regression analysis;
Postoperative complications;
Neoplasm staging
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(3):353-358
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze factors associated with complications after radical surgery for colorectal cancer (CRC).Methods:The clinical data of 150 patients who underwent radical surgery for CRC at Xi'an Aerospace General Hospital between March 2017 and March 2023 were retrospectively analyzed. The incidence of postoperative complications was statistically evaluated. Based on the occurrence of complications, the patients were divided into two groups: an occurrence group ( n = 31) and a non-occurrence group ( n = 119). Univariate analysis was performed to identify factors associated with the incidence of postoperative complications, while logistic regression analysis was performed to determine the independent risk factors for complications following radical surgery for CRC. Results:Complications occurred in 31 patients among 150 patients who underwent radical surgery for CRC, resulting in an overall incidence of 20.67%. The most common complications were pulmonary infections and wound infections. There were no significant differences between the occurrence and non-occurrence groups regarding sex, age, body mass index, history of smoking, history of hypertension, preoperative white blood cell count, preoperative hemoglobin level, anesthesia method, tumor location, tumor size, or intraoperative blood loss (all P > 0.05). However, significant differences were observed in Dukes staging: the occurrence group had 21 patients in stage C, while the non-occurrence group had 50 patients in the same stage. In the occurrence group, there were 8 patients with poorly differentiated tumors, compared to 3 patients in the non-occurrence group. Additionally, 24 patients in the occurrence group had a history of diabetes, while 112 patients in the non-occurrence group reported the same. Open surgery was performed in 14 patients in the occurrence group, compared to 28 patients in the non-occurrence group. The American Society of Anesthesiologist classification indicated that there were 23 patients in the Ⅲ-Ⅳ category in the occurrence group, compared to 45 patients in the non-occurrence group. Furthermore, 21 patients in the occurrence group had surgical durations of 150 minutes or more, compared to 25 patients in the non-occurrence group. All these factors exhibited statistically significant differences between the two groups (all P < 0.05). Logistic multivariate regression analysis indicated that the independent risk factors for postoperative complications in CRC patients included Dukes stage C ( OR = 2.149, P < 0.001, 95% CI: 1.423-2.875), poorly differentiated tumors ( OR = 2.487, P = 0.001, 95% CI: 1.225-3.749), a history of diabetes ( OR = 2.812, P < 0.001, 95% CI: 1.605-4.20), open surgery ( OR = 2.67, P = 0.002, 95% CI: 1.166-4.174), The American Society of Anesthesiologist classification Ⅲ-Ⅳ category ( OR = 3.32, P < 0.001, 95% CI: 2.091-4.549), and surgical duration ≥ 150 minutes ( OR = 6.514, P < 0.001, 95% CI: 3.168-9.861). Conclusions:Numerous factors can influence the occurrence of complications following radical surgery for CRC. Clinicians should pay special attention to these factors and implement targeted prevention and control measures to reduce the incidence of postoperative complications.