Lymphopenia and C-reactive protein elevation on postoperative day 2 are independent risk factors for occurrence of major and minor complications in elective colorectal cancer surgery.

Abstract

Purpose: Early detection is the most critical factor in effectively managing complications following routine colorectal surgery. This study aimed to identify the most effective and useful factors related to body composition and inflammation in the selection of high-risk groups for postoperative complications.

Methods: A retrospective review of 109 patients who underwent elective surgery between January 2021 and May 2023 was conducted. Patients were categorized according to the Clavien-Dindo classification into those discharged without complications (grade 0), those with minor complications (grades 1 and 2), and those with major complications (grade 3+). The characteristics of patients without complications and those with minor or major complications were compared.

Results: Twenty patients developed only minor complications. Bowel obstruction at diagnosis and elevated C-reactive protein (CRP) levels at 2 days postoperatively were statistically significant factors. Eleven patients experienced major complications, and a low lymphocyte count at 2 days postoperatively was a significant predictor of complications. Receiver operating characteristic analysis revealed that CRP levels >125.6 mg/L on postoperative day 2 and lymphocyte count <905 cells/µL were associated with a higher likelihood of minor and major complications.

Conclusion: These findings suggest that monitoring inflammatory markers on postoperative day 2 may help identify patients at risk of complications, enabling early intervention. Further prospective studies are warranted to validate these predictive markers and improve surgical outcomes.