ObjectiveTo investigate the clinical value of the C-reactive protein (CRP) ratio (CRP value on postoperative day 3/day 1) as an early predictor of postoperative severe complication after laparoscopic gastrectomy (LG) for gastric cancer.MethodsThis retrospective study examined the relationship between the occurrence of severe complication and the CRP ratio of 259 gastric cancer patients, who underwent LG in the Department of General Surgery of General Hospital of Fuxin Mining Industry Group of Liaoning Health Industry Group from January 2015 to January 2020. According to Clavien-Dindo (CD) grading system, gastric cancer patients were divided into the severe postoperative complication group (n=41, 15.8%) and the non-severe postoperative complication group (n=218, 84.2%). The relationship between CRP ratio and clinicopathologic characteristics of patients and the predictive value of CRP ratio for severe complication were analyzed.ResultsThe optimal cutoff value of CRP ratio of 2.2 offered 63.2% sensitivity, 91.0% specificity, 70.7% positive predictive value, and 85.8% negative predictive value for severe postoperative complication. The area under the receiver operating characteristic curve was 0.766. There had distinct differences (P<0.05) on body mass index, preoperative comorbidity, type of surgery, T stage, and TNM stage between the high CRP ratio group (CRP ratio >2.2, n=60) and the low CRP ratio group (CRP ratio ≤2.2, n=199). Logistic regression showed that preoperative comorbidity [OR=3.624, 95%CI (1.191, 11.206), P=0.023], later of TNM stage [OR=9.037, 95% CI (1.729, 47.226), P=0.009], and CRP ratio >2.2 [OR=20.473, 95%CI (7.948, 52.737), P<0.001] were independent risk factors for postoperative severe complication after LG.ConclusionThere must to be paid enough attention to the CRP ratio >2.2 on the day 1 and 3 after LG, it suggests that there might be a risk of severe postoperative complications.
ObjectiveTo explore the influencing factors of liver dysfunction after laparoscopic gastrectomy for gastric cancer. MethodsThe clinical and pathological data of patients who underwent laparoscopic gastrectomy for gastric cancer at the Gastric Cancer Center of West China Hospital, Sichuan University, from June 2021 to June 2024 were collected. ResultsA total of 282 patients were included. Postoperative liver dysfunction occurred in 211 cases, while 71 cases had normal liver function. The results of multivariate logistic regression analysis showed that female patients [OR=4.87, 95%CI (2.28, 10.43)], increased age [OR=1.04, 95%CI (1.02, 1.07)], history of long-term alcohol consumption [OR=2.91, 95%CI (1.47, 5.76)], prolonged operation time [OR=1.01, 95%CI (1.00, 1.01)], and patients who received neoadjuvant chemotherapy [OR=2.47, 95%CI (1.09, 5.62)] had a significantly higher incidence of postoperative liver function abnormalities (P<0.05). ConclusionFemale patients, older age, a history of alcohol consumption, prolonged operative duration, and receipt of neoadjuvant chemotherapy are associated with a higher incidence of abnormal liver function following laparoscopic radical gastrectomy for gastric cancer. In clinical practice, special attention should be paid to monitoring perioperative liver function changes in patients with these risk factors. Proactive measures to protect perioperative liver function are warranted to improve patients’ quality of life.