Preoperative white blood cell count predicts anastomotic leakage in patients with left-sided colorectal cancer

To determine whether preoperative white blood cell (WBC) counts reflect risk of anastomotic leak (AL) for patients with colorectal cancer (CRC), we retrospectively examined data from records of 208 consecutive patients who had undergone resections for left-sided CRC, including their clinicopathologi...

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Bibliographic Details
Published in:PloS one 2021-10, Vol.16 (10), p.e0258713-e0258713
Main Authors: Morimoto, Masaki, Taniguchi, Kenjiro, Yamamoto, Osamu, Naka, Takuji, Sugitani, Atsushi, Fujiwara, Yoshiyuki
Format: Article
Language:English
Subjects:
Abscesses
Anastomotic leak
Antibiotics
Anus
Biology and Life Sciences
Blood
Blood cell count
Blood platelets
Body mass index
C-reactive protein
Cancer
Care and treatment
Chemotherapy
Colorectal cancer
Colorectal carcinoma
Colorectal surgery
Diabetes
Gastrointestinal surgery
Health aspects
Hospitals
Inflammation
Laboratories
Laparoscopy
Laparotomy
Leukocytes
Leukocytes (neutrophilic)
Likelihood ratio
Lymphocytes
Medicine and Health Sciences
Monocytes
Mortality
Multivariate analysis
Neutrophils
Ostomy
Patients
Peritonitis
Platelets
Proteins
Risk analysis
Risk factors
Smoking
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Summary:To determine whether preoperative white blood cell (WBC) counts reflect risk of anastomotic leak (AL) for patients with colorectal cancer (CRC), we retrospectively examined data from records of 208 consecutive patients who had undergone resections for left-sided CRC, including their clinicopathological parameters and preoperative laboratory data. The diagnostic value of WBC count for AL was evaluated and compared with those of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio and platelet count × C-reactive protein level multiplier (P-CRP) value; optimal cut-off values were derived from receiver operating characteristic curves. AL was observed in 11 of the 208 patients (5.3%). Compared with the no-AL group, the AL group had a significantly higher mean WBC count and smoking rate. In multivariate analysis, WBC count and smoking were independent risk factors for AL. Compared with the other tested inflammatory indicators, the cut-off value for WBC (6,200/μL) had the highest sensitivity (81.8%) and negative predictive value (98.4%), as well as the lowest likelihood ratio (0.289). Preoperative WBC count could therefore be a convenient predictor of AL in patients with left-sided CRC.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0258713