AUTHOR=Xu Fengming , Meng Cong , Yang Zhengyang , Li Haoze , Gao Jiale , Sun Liting , Zhang Xiao , Wei Qi , Wu Guocong , Yao Hongwei , Zhang Zhongtao 

TITLE=Prognostic nutrition index predicts short-term surgical complications in patients with rectal cancer after laparoscopic surgery

JOURNAL=Frontiers in Surgery

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1000108

DOI=10.3389/fsurg.2022.1000108

ISSN=2296-875X

ABSTRACT=Abstract
Purpose: Surgical complications following laparoscopic rectal cancer surgery remain a major clinical problem. The prognostic nutritional index (PNI) is reportedly associated with postoperative outcomes. We aimed to evaluate the correlation between PNI and short-term surgical complications in patients with rectal cancer after laparoscopic surgery. 
Methods: The prospective clinical data of 225 patients with rectal cancer receiving laparoscopic surgery between January 2021 and April 2022 were analyzed. The cut-off values and diagnostic accuracy of PNI preoperatively and on postoperative day (POD) 1 were determined using receiver operating characteristic (ROC) curves. Univariate and multivariate analyses were performed to identify clinical characteristics and risk factors for surgical complications.
Results: In total, 81 (36.0%) patients developed surgical complications. The optimal cut-off value for preoperative PNI was 40.15, and that for PNI on POD 1 was 35.28. The DeLong test found no statistically between–group difference in the area under the ROC curve (P=0.598). Multivariate analysis identified that a preoperative PNI ≤ 40.15 (odds ratio [OR]: 2.856, 95% confidence interval [CI]: 1.287–6.341, P= 0.010) and PNI on POD 1 ≤ 35.28 (OR: 2.773, 95% CI: 1.533–5.016, P=0.001) were independent risk factors for surgical complications. Patients with a preoperative PNI ≤ 40.15 or PNI on POD 1 ≤ 35.28 were more likely to have surgical complications after laparoscopic surgery for rectal cancer (61.1% vs. 31.2%, P=0.001; 53.0% vs. 28.9%, P=0.001).
Conclusions: Preoperative and POD 1 PNI were independent predictors of surgical complications after laparoscopic surgery for rectal cancer.