Background: Minimally invasive surgery has become the gold standard for colorectal cancer treatment. Approximately 40% of patients undergoing elective colorectal resection develop postoperative complications. The median time to clinical diagnosis of a postoperative complication ranges between 5 and 8 days. Early detection of complications can reduce their morbidity and negative impact. This study aims to evaluate the effectiveness of routine postoperative inflammatory markers in predicting early postoperative complications in patients undergoing elective minimally invasive surgery for colorectal cancer.

Methods: This study was conducted at a single center and is a retrospective analysis of a prospectively mantained database. We included 397 consecutive patients who underwent elective minimally invasive surgery for colorectal cancer between May 2012 and September 2023. Routine inflammatory parameters, including C-reactive protein, Glasgow Prognostic Score, and neutrophil-lymphocyte ratio, were analyzed to identify those associated with postoperative complications. The cutoff values for these markers were determined using receiver-operating characteristic (ROC) curve analysis with the Youden index method.

Results: Of the patients, 29.2% experienced postoperative complications, with major complications (Clavien-Dindo ≥ III) occurring in 11.3%. On postoperative day 3, C-reactive protein level < 125 mg/L, Glasgow Prognostic Score < 2.12, and neutrophil-lymphocyte ratio < 5.26 were significantly associated with lower risk of postoperative complications (p < 0.0001). NLR was the best parameter to identify patients unlikely to experience a postoperative complication on day 3, with a cutoff value of 5.26 and a negative predictive value (NPV) of 83%.

Conclusions: Neutrophil-lymphocyte ratio, C-reactive protein, and Glasgow Prognostic Score on POD3 can predict postoperative complications in patients who undergoing minimally invasive surgery for colorectal cancer. These inflammatory markers demonstrated high negative predictive value, effectively identifying patients who are unlikely to develop complications and providing valuable information for safe early discharge.

Keywords: Colorectal cancer; Early discharge; Inflammatory markers; Minimally invasive surgery.

© 2025. The Author(s).

背景： 微创手术已成为结直肠癌治疗的金标准。约40%接受择期结直肠切除术的患者会出现术后并发症。临床诊断术后并发症的中位时间在5到8天之间。早期检测并发症可以降低其发病率和负面影响。本研究旨在评估常规术后炎症标志物在预测接受择期微创手术结直肠癌患者的早期术后并发症方面的有效性。

方法： 本研究在一个单一中心进行，是对前瞻性维护数据库的回顾性分析。我们纳入了2012年5月至2023年9月期间连续接受择期微创手术结直肠癌治疗的397名患者。通过分析常规炎症参数（包括C反应蛋白、格拉斯哥预后评分和中性粒细胞-淋巴细胞比值），确定与术后并发症相关的标志物。使用接收者操作特性(ROC)曲线分析方法计算这些标记物的最佳截断值。

结果： 患者中有29.2%出现术后并发症，其中重大并发症（Clavien-Dindo III级及以上）发生率为11.3%。术后第3天C反应蛋白水平

结论： 中性粒细胞-淋巴细胞比值、C反应蛋白以及格拉斯哥预后评分在术后第3天可以预测接受微创手术结直肠癌患者的术后并发症。这些炎症标志物具有很高的阴性预测价值，能够有效识别不太可能出现并发症的患者，并为安全早期出院提供有价值的信息。

关键词： 结直肠癌；早期出院；炎症标志物；微创手术。