Abstract 413P
Background
Surgical site infection (SSI) remains a frequent complication of elective colorectal cancer surgery. Butyrylcholinesterase (BChE), which is a cholinesterase enzyme synthesized in the liver, decreases in many clinical conditions such as liver damage, malnutrition, injury, and inflammation. The purpose of this study was to evaluate the efficacy of BChE as a tool for the diagnosis of SSI in elective operations for colorectal cancer.
Methods
Between June 2019 and March 2021, 196 consecutive patients who underwent elective colorectal cancer surgery were enrolled prospectively. Serum BChE concentrations were measured preoperatively and on postoperative (POD) days 1, 3, and 5. Group A included patients with SSI and Group B non-SSI patients. The normal range of BChE is roughly from 2800 U/L to 7400 U/L in our hospital laboratory. Statistical analyses were done using Stata13. Student’s t-test for normally distributed variables and Mann-Whitney U test for skewed variables were used to compare results between groups.
Results
SSI developed in 38 of the 196 patients (19.4%). Prior to surgery, there was no statistically significant difference in concentrations of BChE between the SSI and non-SSI groups (mean level of BChE for Group A=5490, Group B=5190; P=0.840). On POD 1 the mean level of BChE was 4680 in patients with wound infections, and 4670 in non-SSI patients (P=0.530). However, on POD 3 and 5 patients with SSI had significantly lower levels of serum BChE (mean level of BChE Group A=3920 vs Group B=4580; P<0.001, and Group A=4170 vs Group B=4770; P=0.002, respectively).
Conclusions
The current study demonstrates that BChE on POD 3 and 5 is a reliable marker for the presence of SSI in patients undergoing elective operations for colorectal cancer. According to the results of our study, serum BChE assessment could be included in routine clinical diagnostic procedures to evaluate patient postoperative infectious complications like SSI.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.