Can Intraoperative Hyperlactatemia Influence Early Postoperative Infections in Patients Undergoing Laparoscopic Colorectal Cancer Surgery?

Abstract

Introduction:The impact of major surgery on tissue hypoxia can be evaluated indirectly with lactate at the end of the operation. This study aimed to investigate the impact of hyperlactatemia on early postoperative infectious complications at the end of surgery. Materials and Methods:We retrospectively examined 75 patients who underwent laparoscopic resection for colorectal cancer (CRC). Lactate levels above 2 mm/L was defined as hyperlactatemia at the end of the surgery. Postoperative infectious complications occurred within the first 30 days were included in the study. The patients were divided into two groups as those with and without postoperative infection (POI).Results: Nineteen patients (25.3%) had early POI complications. Patients in the POI group had a significant association with the Charlson Comorbidity Index (CCI) ≥3 (p=0.021) and type 2 diabetes mellitus (DM) (p=0.003). Hyperlactatemia was found to significsantly affect POI (p=0.013). Lactate levels increased in 16 (84.2%) of 19 POI patients. While the median value for the hospital stay was 7 days for those without POI, it was 11 days for those with POI (p=0.002). There was a significant relationship between general surgery site infection l (SSI) and diabetes mellitus (p=0.006), and length of hospital stay (p=0.001). Conclusion:In this study, CCI ≥3, type 2 DM, and hyperlactatemia at the end of the operation were independent risk factors for POI in laparoscopic colorectal cancer surgery patients. SSI and POI may predict the prolonged hospital stay. To validate these findings, studies with a higher patient volume in a prospective design are required.