Determination of predictive factors for complications in elective surgery of colorectal cancer patients. Experience of the instituto de cancerología las américas auna (colombia, 2016-2019)

Abstract

Introduction. The fundamental pillar of colorectal cancer treatment is surgery, a situation that exposes patients to the possible presentation of complications, morbidity and mortality, poor quality of life, tumor recurrence or death. The objective of this study was to determine the clinical and surgical variables that affect the risk of the appearance of complications in colorectal cancer patients taken to elective surgery between 2016 and 2019. Methods. Observational, descriptive, cross-sectional and retrospective study. Patients over the age of 18 with colorectal cancer undergoing elective surgery were included. A multivariate analysis was performed to determine the factors related to postsurgical complications. Results. We included 298 patients, 68% over 60 years of age, 52.3% women, 74.2% had comorbidities and 48.3% were diagnosed in stage III. 48.3% presented postoperative complications; of these, 68.1% had no nutritional screening, and 61.8% had no colon preparation; 55% were rectal cancer surgeries, 69.1% underwent laparoscopic surgeries, and 71.8% had bleeding less than 500 ml. Most complications were classified as Clavien Dindo I-III. Discussion. The characteristic of the patients was similar to those presented in other studies, even though we had more incidence of postoperative ileus. The multivariate analysis showed a higher probability of complications in patients with: diabetes, hypertension, lack of nutritional screening, bleeding over 500cc, lack of colon mechanical preparation and rectal cancer surgery. Patient characteristics were similar to those presented in other studies, although there was a higher incidence of postoperative ileus. The multivariate analysis showed a greater probability of presenting a complication in patients with diabetes mellitus, arterial hypertension, lack of nutritional screening, colon preparation, rectal cancer surgery, and bleeding greater than 500 ml.