The effecting factors on the postop morbidity in patients who had gastric or CR resection due to GI cx: Does preop nutritional status affect postop morbidity?

Emine O Gur, Osman N Dilek, Oguzhan Ozsay, Turan Acar, Kemal Atahan, Erdinc Kamer, Haldun Kar, Mehmet Haciyanli. Katip Celebi Univercity Ataturk Research and Educational Hospital General Surgery Department

Introduction: Preoperative nutritional status of the patients is an important factor for the postoperative morbidity. Preoperative evaluation of the nutritional status of the patients with gastric or colorectal cancer can alert the surgeon about postoperative morbidity. There are several methods to evaluate nutritional performance of the patients. Nutritional risk screening 2002 (NRS-2002) is one of them. The aim of the present study is to detect the effecting factors on postoperative morbidity of gastric or colorectal resection because of the cancer and to evaluate the predictive value of preoperative NRS-2002 score on postoperative morbidity.

Methods and Procedures: The patients who were performed on gastric resection or colorectal resection because of malignancy were included in the study. Preoperative nutritional status of the patients evaluated with NRS-2002 system. The patients whose NRS-2002 score were lower than 3 points were accepted as good nutritional performance. The effects of the age, sex, the origin of the malignancy, preoperative NRS-2002 score, the quantity of the blood transfusion during operation, stage of the disease, the length of the operation, body mass index, preoperative blood albumin level on morbidity were evaluated statistically. The effect of morbidity on the length of hospital stay was also determined.

Results: 418 patients between January 2012 – December 2014 were included in the study. Ninety-nine of all patients (23.6%) had postoperative morbidity. Gastric resection was performed on 196 (46.8%) patients and colorectal resection was performed on 53.2% of the patients. The 64.1% (268 patients) of the patients were male and the overall age was 61.1± 12.3 (24-88) years. There were 259 patients (61.9%) with good nutritional performance. Postoperative morbidity was developed on 49(18.9%) of the patients who had good nutritional score. The morbidity rate was 31.4% in the patients with poor nutritional performance (p<0.05). The stage of the disease, length of the operation, and the quantity of the blood transfusion during the operation were effecting the morbidity rate significantly (p<0.05). The mortality rate was 2.3% in our study group.

Conclusion: The preoperative nutritional performance, the stage of the disease, length of the operation, and the quantity of the blood transfusion are affecting factors on the postoperative morbidity of the patients who were performed gastric or colorectal resection because of the cancer. The preoperative evaluation of the nutritional status of the patients with NRS-2002 in surgery clinics can be a predicting method for postoperative morbidity on the patients who were performed resection because of gastric or colorectal cancer.