The Value Of Prognostic Nutrition Index In Anastomotic Fistula After Colorectal Cancer Operation

Objective: To investigate the value of prognostic nutrition index(PNI)in the occurrence of anastomotic fistula after laparoscopic radical resection of colorectal cancer.Methods:The basic data of 144 patients who underwent laparoscopic radical resection of colorectal cancer in the First Affiliated Hospital of Chongqing Medical University from July 2018 to June 2019 were collected and retrospectively analyzed,including 75 males and 69 females.Age 30-90 years old;Preoperative hypertension in 29 cases,diabetes in 15 cases,intestinal obstruction in 22 cases;Preoperative radiotherapy was performed in 4 cases and chemotherapy in 6 cases.Tumor distance from anal margin≤7cm in 35 cases,> 7cm in 109 cases;The operation time ≥4h in 57 cases and < 4h in 87 cases;The degree of tumor differentiation: 21 cases were poorly differentiated,115 cases were moderately differentiated,and 8 cases were highly differentiated.TNM stage: 23 patients with stage I,62 patients with stage II,45 patients with stage III,and 14 patients with stage IV.The patients were divided into anastomotic fistula group and non-anastomotic fistula group.The risk factors affecting the occurrence of anastomotic fistula were analyzed by multivariate factors.The ROC curve was used to explore the value of PNI value on the third day after surgery in predicting the occurrence of anastomotic fistula.Results: Anastomotic fistula occurred in 13 of 144 patients undergoing laparoscopic radical resection of colorectal cancer,and the incidence of anastomotic fistula was 9.0%.No patient died during hospitalization.The incidence of anastomotic fistula was related to the distance from the tumor to the anal margin ≤7cm(P < 0.001),preoperative radiotherapy(P=0.041),chemotherapy(P=0.010),and operation time(P=0.022).The incidence of anastomotic fistula increased with the decrease of PNI and the increase of NLR on the third day after surgery(P <0.05).The area under the curve of PNI and NLR to predict the occurrence of anastomotic fistula were 0.687 and 0.811,respectively,and the cutoff values were 34.02 and 12.01,respectively,P < 0.05.Conclusion: PNI and NLR measurements on the 3rd day after operation have certain predictive value on the occurrence of anastomotic fistula after laparoscopic radical resection of colorectal cancer.