Abstract:

Objective

To investigate the predictive value of preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immunoinflammatory index (SII)for intestinal obstruction after radical resection of colorectal cancer under general anesthesia.

Methods

A total of 200 patients who underwent radical resection of colorectal cancer under general anesthesia in Baoji Central Hospital from January 2023 to January 2025 were selected as the study objects, according to whether postoperative intestinal obstruction occurred, they were divided into postoperative intestinal obstruction (POI) group (n=30) and non-POI group (n=170).Age, gender, body mass index, comorbidities(hypertension, diabetes, coronary heart disease), tumor site, tumor TNM stage, pathological type, degree of differentiation, tumor size, operation time, preoperative NLR, PLR and SII levels were collected.Logistic regression analysis was used to screen the influencing factors of intestinal obstruction after radical resection of colorectal cancer under general anesthesia, and receiver operating characteristics (ROC) curve was drawn to evaluate the predictive value of NLR, PLR and SII levels in postoperative intestinal obstruction.

Results

There was no significant difference in age, sex, body mass index, comorbidities,tumor site, pathological type, differentiation degree, tumor size and operation time between the two groups(P>0.05).The proportion of TNM stage Ⅲ in POI group was higher than that in non-POI group, and preoperative NLR, PLR and SII levels were higher than those in non-POI group (P<0.05).Logistic regression analysis showed that TNM stage Ⅲ, preoperative NLR, PLR and SII levels were all risk factors for postoperative intestinal obstruction after radical resection of colorectal cancer under general anesthesia(P<0.05).ROC curve analysis results showed that the AUC of preoperative NLR, PLR and SII predicting intestinal obstruction after radical resection of colorectal cancer under general anesthesia were 0.756 (95%CI 0.652-0.860), 0.836 (95% CI 0.739-0.932) and 0.752 (95% CI 0.650-0.853), the corresponding sensitivities were 56.7%, 76.7% and 46.7%, and the specificities were 90.0%, 87.1% and 97.6% (P<0.05).

Conclusion

The preoperative levels of NLR, PLR, and SII are closely related to the occurrence of intestinal obstruction after radical resection of colorectal cancer under general anesthesia, which can be used as potential indicators to predict postoperative intestinal obstruction and provide reference for early clinical intervention.

Key words: Colorectal cancer, Intestinal obstruction, Neutrophil to lymphocyte ratio, Platelet to lymphocyte ratio, Systemic immunoinflammatory index