内容紹介
Preoperative Prognostic Nutrition Index Is a Predictive Factor of Complications in Laparoscopic Colorectal Surgery
Summary
Paitients and methods: We retrospectively reviewed a database of 188 patients who underwent resection for colorectal cancer with laparoscopic surgery between July 2007 and March 2015. The prognostic nutrition index(PNI), modified Glasgow prognostic score(mGPS), controlling nutritional status(CONUT), and neutrophil/lymphocyte ratio(N/L)were measured in these patients. We examined the association between postoperative complications and clinicopathological factors. Results: The study included 110 men and 78 women. Median age was 68 years. The site of the primary lesion was colon in 118 and rectum in 70 patients. Postoperative complications higher than GradeⅡ(Clavien-Dindo classification)were reported in 24(12.8%)patients: Surgical site infection(SSI)in 12, remote infection in 7, ileus in 5, and others in 2 patients. Clinicopathological factors related to complications were rectal surgery, large amount of intraoperative bleeding, and long operative time. The related immunologic and nutritional factors were mGPS 2, PNI below 40, and N/L above 3. CONUT was not associated with complications in our cases. Conclusions: mGPS, PNI, and N/L are predictive factors for complications in laparoscopic colorectal surgery.
要旨
対象・方法: 2007年7月～2015年3月までに鏡視下手術を行った大腸癌症例のうち,免疫・栄養指数として小野寺式栄養指数(PNI),modified Glasgow prognostic score(mGPS),controlling nutritional satatus(CONUT),好中球/リンパ球比(N/L)を測定し得た188例を対象とし,合併症発症と各臨床病理学的因子との関連を検討した。結果: 背景因子をみると年齢68(38～91)歳,男性110例,女性78例,占居部位は結腸118例,直腸70例であった。Clavien-Dindo分類GradeⅡ以上の術後合併症は24例(12.8%)に認め,手術部位感染12例,遠隔感染7例,イレウス5例,その他2例であった。合併症発症は,占居部位が直腸,出血量が多い例,長時間手術例に多く,免疫・栄養指数との関連をみると,CONUTは関連がなかったが,mGPS 2,PNI 40以下,N/Lが3以上の症例で合併症発症が多かった。結語: 大腸癌に対する鏡視下手術において,免疫・栄養指数であるmGPS,PNI,N/Lは術後合併症の予測因子となると考えられた。
目次
Summary
Paitients and methods: We retrospectively reviewed a database of 188 patients who underwent resection for colorectal cancer with laparoscopic surgery between July 2007 and March 2015. The prognostic nutrition index(PNI), modified Glasgow prognostic score(mGPS), controlling nutritional status(CONUT), and neutrophil/lymphocyte ratio(N/L)were measured in these patients. We examined the association between postoperative complications and clinicopathological factors. Results: The study included 110 men and 78 women. Median age was 68 years. The site of the primary lesion was colon in 118 and rectum in 70 patients. Postoperative complications higher than GradeⅡ(Clavien-Dindo classification)were reported in 24(12.8%)patients: Surgical site infection(SSI)in 12, remote infection in 7, ileus in 5, and others in 2 patients. Clinicopathological factors related to complications were rectal surgery, large amount of intraoperative bleeding, and long operative time. The related immunologic and nutritional factors were mGPS 2, PNI below 40, and N/L above 3. CONUT was not associated with complications in our cases. Conclusions: mGPS, PNI, and N/L are predictive factors for complications in laparoscopic colorectal surgery.
要旨
対象・方法: 2007年7月～2015年3月までに鏡視下手術を行った大腸癌症例のうち,免疫・栄養指数として小野寺式栄養指数(PNI),modified Glasgow prognostic score(mGPS),controlling nutritional satatus(CONUT),好中球/リンパ球比(N/L)を測定し得た188例を対象とし,合併症発症と各臨床病理学的因子との関連を検討した。結果: 背景因子をみると年齢68(38～91)歳,男性110例,女性78例,占居部位は結腸118例,直腸70例であった。Clavien-Dindo分類GradeⅡ以上の術後合併症は24例(12.8%)に認め,手術部位感染12例,遠隔感染7例,イレウス5例,その他2例であった。合併症発症は,占居部位が直腸,出血量が多い例,長時間手術例に多く,免疫・栄養指数との関連をみると,CONUTは関連がなかったが,mGPS 2,PNI 40以下,N/Lが3以上の症例で合併症発症が多かった。結語: 大腸癌に対する鏡視下手術において,免疫・栄養指数であるmGPS,PNI,N/Lは術後合併症の予測因子となると考えられた。