RISK FACTORS FOR THE OCCURRENCE OF POSTOPERATIVE COMPLICATIONS IN COLECTOMIZED PATIENTS FOR THE TREATMENT OF COLORECTAL CANCER: A CASE-CONTROL STUDY

Abstract

Introduction: Colorectal neoplasia is the most common cancer of the gastrointestinal tract, and surgery is the gold standard for its treatment in cases of resectable, non-metastatic cancer. Many comorbidities and complications are associated with patients undergoing colectomy for cancer treatment. Objective: To understand the comorbidities and complications in patients who underwent colectomy for colorectal cancer treatment. Materials and Methods: This is a case-control study conducted through electronic medical records of patients undergoing surgery for colorectal cancer treatment at Hospital São José do Avaí (Itaperuna, Rio de Janeiro) over a period of 10 years (January 2010 to December 2020). Cases included colectomized patients who experienced postoperative complications, and controls were those without complications. Study data were stored in an Excel spreadsheet and processed using SPSS Statistics 26. Chi-square tests were performed for bivariate analysis, and variables with p > 0.3 proceeded to multivariate analysis. Results: The age range of the 203 colectomized patients analyzed was 53 to 74 years and was not statistically significant for complication occurrence (p = 0.881). Of all patients, 47.5% were men and 52.2% were women; gender was not statistically significant for complication occurrence (p = 0.455). The main surgical techniques used were rectosigmoidectomy (43.4%), right colectomy (25.0%), and left colectomy (21.9%). The most observed post-colectomy complications were anastomotic fistula (8.9%), abscess (6.9%), and complications related to protective colostomy and ileostomy (4.4%). Among the analyzed risk factors, previous surgery (OR = 2.6; CI = 1.2-5.4; p = 0.000), radiotherapy (OR = 6.5; CI = 2.5-16.6; p = 0.000), and chemotherapy (OR = 6.059; CI = 2.5-14.6; p = 0.009) showed statistically significant differences for complication occurrence. Conclusion: Previous surgery, chemotherapy, and radiotherapy demonstrated influence on the occurrence of complications after colectomy in patients with colorectal cancer.