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

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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.

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Data availability

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

ASA-PS:

American Society of Anesthesiologists physical status

BMI:

Body mass index

CAR:

C-reactive protein to albumin ratio

ChE:

Cholinesterase

CI:

Confidence interval

CRC:

Colorectal cancer

CT:

Computed tomography

NLR:

Neutrophil-to-lymphocyte ratio

N.S:

Not significant

PNI:

Prognostic nutritional index

SMI:

Skeletal muscle index

SSI:

Surgical site infection

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Funding

The authors have no conflicts of interest to report. The manuscript was not prepared or funded by a commercial organization. The present study was approved by the Institutional Ethics Committee of Tokyo General Hospital and conformed to the ethical guidelines of the Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Surgery, Tokyo General Hospital, Tokyo, Japan

    Yasuhiro Takano, Wataru Kai, Shu Tsukihara, Yasunobu Kobayashi, Daisuke Ito, Hironori Kanno, Kyonsu Son & Nobuyoshi Hanyu

  2. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Koichiro Haruki & Ken Eto

Authors
  1. Yasuhiro Takano
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  2. Koichiro Haruki
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  3. Wataru Kai
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  4. Shu Tsukihara
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  5. Yasunobu Kobayashi
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  6. Daisuke Ito
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Correspondence to Koichiro Haruki.

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Takano, Y., Haruki, K., Kai, W. et al. The influence of serum cholinesterase levels and sarcopenia on postoperative infectious complications in colorectal cancer surgery. Surg Today 53, 816–823 (2023). https://doi.org/10.1007/s00595-022-02625-1

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