Relationship of neutrophil-to-lymphocyte ratio with anastomosis leakage as complication of colorectal surgery in colorectal cancer patients

Abstract

Background: The literature examining the relationship between the elevated neutrophil-to-lymphocyte ratio (NLR) and the incidence of postoperative complications is varied. The primary object of this investigation was to determine the relationship between the NLR with the occurrence of the anastomotic leak as a complication after colorectal surgery in colorectal cancer patients. Methods: This is observational cross-sectional study of 54 patients with colorectal cancer patients underwent elective surgery at the Central Operating Theatre Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia, in 2018-2019. Lymphocytes and neu-trophils are taken from complete blood count values of colorectal cancer patients one day before colorectal surgery. Univariate analysis was carried out to describe the characteristics of the subjects. Bivariate analysis is performed using the independent t-test if the data is normally distributed. Results: Mean neutrophil value was significantly higher in subjects with anastomotic leakage than in those without a leak, which was 9.91 compared to 5.44 (p <0.05). The mean value of percentages of lymphocytes was significantly (p <0.05) lower in subjects with anastomotic leakage compared to those without leakage, which was 14.50 compared to 30.15. The mean NLR value was found to be higher in subjects with anastomotic leak compared to those without leakage, which was 8.60 compared to 5.17 although it was not statistically significant (p> 0.05). Conclusions: There is no relationship between NLR values and complications of postoperative colorectal anastomosis leak in colorectal cancer patients. The mean NLR value was found to be higher in subjects who experienced anastomotic leak compared to those without leakage. The neutrophil rate was significantly higher and the lymphocyte rate was lower in subjects who experienced anastomotic leakage compared to those without leakage.