BACKGROUND: Colorectal cancer (CRC) has one of the highest morbidity and mortality rates among digestive tract tumors. Intra-abdominal infection (IAI) is a common postoperative complication that affects the clinical outcomes of patients with CRC and hinders their rehabilitation process. However, the factors influencing abdominal infection after CRC surgery remain unclear; further, prediction models are rarely used to analyze preoperative laboratory indicators and postoperative complications.
OBJECTIVE: To explore the predictive value of preoperative blood markers for IAI after radical resection of CRC.
METHODS: The data of 80 patients who underwent radical resection of CRC in the Anorectal Surgery Department of Suzhou Hospital affiliated with Anhui Medical University were analyzed. These patients were categorized into IAI (n = 15) and non-IAI groups (n = 65) based on whether IAI occurred. Influencing factors were compared; general data and laboratory indices of both groups were identified. The relationship between the indicators was assessed. Further, a nomogram prediction model was developed and evaluated; its utility and clinical applicability were assessed.
RESULTS: The risk factors for IAI after radical resection of CRC were neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and carcinoembryonic antigen (CEA) levels. NLR was correlated with PLR and SII (r = 0.604, 0.925, and 0.305, respectively), while PLR was correlated with SII (r = 0.787). The nomogram prediction model demonstrated an area under the curve of 0.968 [95% confidence interval (CI): 0.948-0.988] in the training set (n = 60) and 0.926 (95%CI: 0.906-0.980) in the validation set (n = 20). The average absolute errors of the calibration curves for the training and validation sets were 0.032 and 0.048, respectively, indicating a good model fit. The decision curve analysis curves demonstrated high net income above the 5% threshold, indicating the clinical practicality of the model.
CONCLUSIONS: The nomogram model constructed using NLR, PLR, SII, and CEA levels had good accuracy and reliability in predicting IAI after radical resection of CRC, potentially aiding clinical treatment decision-making.

OBJECTIVE: The use of goal-directed fluid therapy (GDFT) has been shown to reduce complications and improve prognosis in high-risk abdominal surgery patients. However, the utilization of pulse pressure variation (PPV) guided GDFT in laparoscopic surgery remains a subject of debate. We hypothesized that utilizing PPV guidance for GDFT would optimize short-term prognosis in elderly patients undergoing laparoscopic radical resection for colorectal cancer compared to conventional fluid therapy.
METHODS: Elderly patients undergoing laparoscopic radical resection of colorectal cancer were randomized to receive either PPV guided GDFT or conventional fluid therapy and explore whether PPV guided GDFT can optimize the short-term prognosis of elderly patients undergoing laparoscopic radical resection of colorectal cancer compared with conventional fluid therapy.
RESULTS: The incidence of complications was significantly lower in the PPV group compared to the control group (32.8% vs. 57.1%, P = .009). Additionally, the PPV group had a lower occurrence of gastrointestinal dysfunction (19.0% vs. 39.3%, P = .017) and postoperative pneumonia (8.6% vs. 23.2%, P = .033) than the control group.
CONCLUSIONS: Utilizing PPV as a monitoring index for GDFT can improve short-term prognosis in elderly patients undergoing laparoscopic radical resection of colorectal cancer.
BACKGROUND: ChiCTR2300067361; date of registration: January 5, 2023.

To investigate the short-term efficacy of laparoscopic radical resection for colorectal cancer with bowel obstruction and the effects of the surgery on inflammatory factors for improving the clinical treatment of the condition.
The data of colorectal cancer patients presenting bowel obstruction (n = 167) treated at our hospital from January 2019 to December 2020 were assessed. The patients were divided into a laparoscopic radical resection of colorectal cancer group (LRRCC, n = 90) and open surgery group (OP, n = 77). Before treatment and on the 1st, 3rd, 5th, 7th and 15th day after treatment, their serum levels of pain factors, neuropeptide Y, prostaglandin E2 and nerve growth factor were measured by a serum biochemistry analyzer, their levels of inflammatory factors including C-reactive protein, interleukin 6 (IL-6), IL-8 and tumor necrosis factor-α by ELISA, and their amount of CD3+, CD4+ and CD8+ T cell subsets were measure by flow cytometry. Anorectal motility was assessed before and 4 and 8 weeks after treatment. Survival rates were assessed using the Kaplan-Meier method.
On the 1st, 3rd, 5th, 7th and 15th day after treatment, compared with the OP group, the LRRCC group had lower levels of serum pain factors, inflammatory factors and CD8+T lymphocytes, while their numbers of CD3+ and CD4+ T lymphocytes subsets were significantly increased. Further, the LRRCC group had fewer complications and significantly higher survival rates, demonstrating better efficacy than the OP group.
Laparoscopic radical resection was effective and achieved superior outcomes than open surgery in treating colorectal cancer patients with bowel obstruction.

The study aimed to evaluate the effect of forced-air warming blanket combined with conventional thermal insulation measures on inadvertent perioperative hypothermia (IPH) in elderly patients undergoing laparoscopic radical resection of colorectal cancer. A total of 70 elderly patients undergoing laparoscopic radical resection of colorectal cancer with general anesthesia were included, and divided into conventional warming treatment (CT) group or forced-air warming treatment (FT) group. In the FT group, based on the conventional warming strategy, patients received prewarming with the forced-air warming blanket (38°C) for ≥20 minutes before induction of anesthesia, and received this treatment continuously during operation. The core body temperature, recovery time from anesthesia, extubating time, and length of stay in the postanesthesia care unit were recorded. The incidence of IPH and postoperative shivering was observed. The incidence of IPH was significantly lower, and average minimum body temperature during the operation was significantly higher in the FT group than that in the CT group (5.7% vs. 22.8% and 36.23°C vs. 35.89°C, respectively). The intraoperative body temperature decreased less (0.32°C vs. 0.69°C), the recovery time from anesthesia was faster (12.8 minutes vs. 17.1 minutes), and the incidence of postoperative shivering was less (2.8% vs. 28.6%) in the FT group than the CT group. In elderly patients undergoing laparoscopic radical resection of colorectal cancer, use of forced-air warming blankets combined with conventional warming measures is more effective to maintain normal body temperature during the perioperative period and reduce the incidence of IPH.

This study investigated the application of rapid rehabilitation nursing in postoperative patients with colorectal cancer (CRC) and its effect on quality of life (QOL). A prospective analysis was performed on 154 patients with CRC, after radical resection in The Central Hospital of Wuhan from February 2011 to April 2015. During the perioperative period, 96 patients (study group) received fast-track surgery (FTS) and 58 patients (control group) received routine surgery. The postoperative data of patients in the two groups were analyzed in terms of the first anus exhaustion time, the first time getting out of bed, first time eating liquid food, first defecation time, the time of drainage tube removal, time of gastric tube removal, time of suture removal, hospital stay and surgical expenses. Visual Analogue Scale (VAS) was used to assess postoperative pain. The re-hospitalization rate, the incidence of complications 30 days after operation, the survival and QOL scores were analyzed. After discharge patients were followed up for 3 years to observe the 3-year overall survival (OS). VAS scores were lower in the study group than that in the control group at 6, 12, 24, 48 and 72 h after operation (P<0.05). The re-hospitalization rate and incidence of complications 30 days after operation were lower in the study group than those in the control group (P<0.05). Before nursing, there was no statistically significant difference in QOL score between the two groups (P>0.05), whereas after 3 and 12 months of nursing, QOL score was significantly higher in the study group than that in the control group (P<0.05). QOL score in the two groups increased with time, and there were differences between the two groups at each time-point (P<0.05). There was no significant difference in the 3-year OS between the two groups (P>0.05). In conclusion, effectively improving patients\' psychological state, reducing complications and relieving pain, the FTS during the perioperative period of CRC surgery promotes postoperative rehabilitation, reduces economic pressures and improves QOL.