AUTHOR=Xu Fengming , Meng Cong , Yang Zhengyang , Li Haoze , Gao Jiale , Sun Liting , Zhang Xiao , Wei Qi , Wu Guocong , Yao Hongwei , Zhang Zhongtao 

TITLE=Prognostic nutrition index predicts short-term surgical complications in patients with rectal cancer after laparoscopic surgery

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1000108

DOI=10.3389/fsurg.2022.1000108

ISSN=2296-875X

ABSTRACT=<sec><title>Purpose</title><p>Surgical complications following laparoscopic rectal cancer surgery remain a major clinical problem. The prognostic nutritional index (PNI) is reportedly associated with postoperative outcomes. We aimed to evaluate the correlation between PNI and short-term surgical complications in patients with rectal cancer after laparoscopic surgery.</p></sec><sec><title>Methods</title><p>The prospective clinical data of 225 patients with rectal cancer receiving laparoscopic surgery between January 2021 and April 2022 were retrospectively analyzed. The cut-off values and diagnostic accuracy of PNI preoperatively and on postoperative day (POD) 1 were determined using receiver operating characteristic (ROC) curves. Univariate and multivariate analyses were performed to identify clinical characteristics and risk factors for surgical complications.</p></sec><sec><title>Results</title><p>In total, 81 (36.0%) patients developed surgical complications. The optimal cut-off value for preoperative PNI was 40.15, and that for PNI on POD 1 was 35.28. The DeLong test found no statistically between–group difference in the area under the ROC curve (<italic>P</italic> = 0.598). Multivariate analysis identified that a preoperative PNI ≤40.15 [odds ratio (OR): 2.856, 95% confidence interval (CI): 1.287–6.341, <italic>P</italic> = 0.010] and PNI on POD 1 ≤35.28 (OR: 2.773, 95% CI: 1.533–5.016, <italic>P</italic> = 0.001) were independent risk factors for surgical complications. Patients with a preoperative PNI ≤40.15 or PNI on POD 1 ≤35.28 were more likely to have surgical complications after laparoscopic surgery for rectal cancer (61.1% vs. 31.2%, <italic>P</italic> = 0.001; 53.0% vs. 28.9%, <italic>P</italic> = 0.001).</p></sec><sec><title>Conclusion</title><p>Preoperative and POD 1 PNI were independent predictors of short-term surgical complications after laparoscopic surgery for rectal cancer.</p></sec>