The influence of serum cholinesterase levels and sarcopenia on postoperative infectious complications in colorectal cancer surgery

Surg Today. 2023 Jul;53(7):816-823. doi: 10.1007/s00595-022-02625-1. Epub 2022 Nov 28.

Abstract

Purpose: Cholinesterase is a nutritional marker associated with sarcopenia. The present study evaluated the relationship between cholinesterase and postoperative infectious complications in patients undergoing colorectal resection for colorectal cancer.

Methods: The study involved 231 patients who had undergone colorectal resection for colorectal cancer. We retrospectively investigated the relationship between preoperative serum cholinesterase levels and postoperative infectious complications. Univariate and multivariate analyses were performed to identify independent risk factors for postoperative infectious complications. We then performed stratified analyses to assess the interaction between cholinesterase and clinical variables to predict postoperative infectious complications.

Results: In the multivariate analysis, the body mass index (P = 0.010), serum cholinesterase levels (P = 0.005), sarcopenia (P = 0.003) and blood loss (P < 0.001) were independent risk factors for postoperative infectious complications. In stratified analyses, the association between serum cholinesterase levels and postoperative infectious complications differed by the sarcopenia status (Pinteraction = 0.006).

Conclusion: Preoperative serum cholinesterase levels may be useful for predicting postoperative infectious complications in colorectal cancer surgery. The association differs by the sarcopenia status, suggesting a potential interaction between nutritional markers and sarcopenia.

Keywords: Cholinesterase; Colorectal cancer; Infectious complication; Interaction; Sarcopenia.

MeSH terms

  • Cholinesterases* / blood
  • Colorectal Neoplasms* / complications
  • Colorectal Neoplasms* / surgery
  • Communicable Diseases*
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Sarcopenia* / complications

Substances

  • Cholinesterases