Influence of type II diabetes mellitus on postoperative complications following colorectal cancer surgery

Răzvan Cătălin Popescu; Nicoleta Leopa; Eugen Dumitru; Anca Florentina Mitroi; Cristina Tocia; Andrei Dumitru; Costel Brînzan; Florin Botea

doi:10.3892/etm.2022.11548

Influence of type II diabetes mellitus on postoperative complications following colorectal cancer surgery

Exp Ther Med. 2022 Aug 2;24(4):611. doi: 10.3892/etm.2022.11548. eCollection 2022 Oct.

Authors

Răzvan Cătălin Popescu^{1

2}, Nicoleta Leopa^{1

2}, Eugen Dumitru^{2

3}, Anca Florentina Mitroi⁴, Cristina Tocia^{2

3}, Andrei Dumitru^{2

3}, Costel Brînzan⁴, Florin Botea⁵

Affiliations

¹ Department of General Surgery, Emergency Hospital of Constanța, 900591 Constanța, Romania.
² Faculty of Medicine and Pharmacy Constanta, Ovidius University, 900470 Constanța, Romania.
³ Department of Gastroenterology, Emergency Hospital of Constanța, 900591 Constanța, Romania.
⁴ Department of Pathology, Emergency Hospital of Constanța, 900591 Constanța, Romania.
⁵ Dan Setlacec Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania.

Abstract

Diabetes mellitus (DM) promotes colorectal cancer (CRC) carcinogenesis through complex processes and is considered as an independent risk factor for cancer in general and for CRC in particular. Diabetic patients have complications in the postoperative period following CRC surgery. The aim of the present study was to explore the effect of type II DM (T2DM) on postoperative outcomes for CRC compared with non-diabetic patients. The present study analyzed the data from patients admitted to the General Surgery Department, Emergency Hospital of Constanța (Romania) diagnosed with CRC and DM compared with a control group (patients with CRC, without DM, recruited in the same period and frequency matched to cases by number, sex and age) analyzing patient comorbidities and postoperative complications. A total of 61 patients had undergone surgery for CRC and met the inclusion criteria in the present study conducted during September 2020-2021. A total of 30 patients associated T2DM. Diabetic patients have been associated with more comorbidities than non-diabetics; the age-adjusted Charlson comorbidity index score ≥6 was identified in 90% of diabetic patients compared with 45.2% of controls. Grade III Clavien-Dindo classification was observed in 13.3% diabetic patients compared with 3.2% of non-diabetic patients. Additionally, a higher rate of urinary and pulmonary complications (6.7 vs. 3.2% in controls respectively) in patients with diabetes was found. Postoperative hospitalization was prolonged in diabetic patients (P=0.042). Univariate and multivariate analyses revealed that the laparoscopic approach for diabetic patients was found to be associated with <grade III Clavien-Dindo classification (P=0.040) and the absence of surgical site infection (P=0.040). Diabetes predisposes patients to numerous postoperative complications following CRC surgery and postoperative therapeutic conduct must be personalized to prevent possible postoperative complications following CRC.

Keywords: colorectal cancer; diabetes mellitus; laparoscopy; postoperative complications; surgery.

Grants and funding

Funding: No funding was received.