Analysis of influencing factors and establishment of prediction model to achieve text-book outcome after radical resection of middle and low rectal cancer
Objective To investigate the influencing factors for achieving textbook outcome(TO)after radical re-section of middle and low rectal cancer.Methods A retrospective analysis was conducted on the clinical and pathologi-cal data of 182 patients with middle and low rectal cancer admitted to the Department of Gastrointestinal Surgery in our hospital from Jan.2022 to Feb.2024.TO was defined as meeting all the following conditions simultaneously:no re-intervention,negative tumor margin,postoperative hospital stay≤14 days,no unplanned readmission within 30 days,no death within 90 days,≥12 lymph nodes harvested lymph;and no severe complications postoperatively(Clavien-Dindo classification≥2).Results A total of 182 patients with middle and low rectal cancer were included in the analysis,of which 123(67.58%)patients achieved TO after surgery.All patients achieved negative tumor margins and no death within 90 days;179(98.35%)patients had no re-intervention,162(89.01%)patients had a postoperative stay≤14 days,and 181(99.45%)patients had unplanned readmissions within 30 days.Unplanned rehospitalization,163 pa-tients(89.56%)had≥12 lymph nodes dissected,and 123 patients(67.58%)had no severe postoperative complica-tions.Univariate analysis results showed that there were statistically significant differences between the TO group and the non-TO group in surgical methods,cancer nodules,NLR,PLR,and SII(P<0.05).Multivariate analysis showed that Mi-les surgical method,presence of cancer nodules,and high preoperative SII were independent influencing factors for achieving TO after surgery(P<0.05).Conclusion Miles surgical method,presence of cancer nodules,and high pre-operative SII are independent influencing factors for achieving TO after radical resection of middle and low rectal cancer.
Middle and low rectal cancerText outcomeInfluencing factorsPredictive model
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NSTL
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