Videotorakoskopik wedge rezeksiyon yapılan hastalarda postoperatif komplikasyonları tahmin etmede nötrofil/lenfosit ve platelet/lenfosit oranlarının önemi

Amaç: Postoperatif komplikasyon yoğun bakım ve hastane kalış süresini uzatan, hastane maliyetini artıran önemli bir etkendir. Sistemik enflamasyon bu komplikasyonların oluşumunda önemli bir risk faktörüdür. Bu çalışmada amacımız, videotorakoskopik wedge rezeksiyon uygulanan hastalarda gelişen postopertif komplikasyonlarda Nötrofil/Lenfosit Oranı (NLO) ve Platelet/Lenfosit Oranının (PLO) prediktif önemini ortaya koymaktır. Materyal ve Metod: 2010 ocak ile 2019 aralık arasında interstisyel akciğer hastalığı nedeniyle videotorakoskopik wedge rezeksiyon uygulanan 122 hasta, geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, sigara hikayesi, eşlik eden hastalıklar, yapılan cerrahi işlem, postoperatif komplikasyonlar, preoperatif ve postoperatif lokosit sayısı (WBC), hemoglobin, nötrofil, lenfosit, monosit, platelet, NLO ve PLO değerleri dosyalardan elde edildi. Postoperatif komplikasyon gelişen hastalar grup 1 kabul edilirken, komplikasyon gelişmeyenler grup 2 olarak sınıflandırıldı. Postoperatif komplikasyonlar ile laboratuvar bulguları arasında istatistiksel olarak anlamlı bir ilişki olup olmadığına bakıldı. Bulgular: Toplam 18 (%14) hastada postoperatif komplikasyon gelişti. Komplikasyon olarak uzamış hava kaçağı 6, atelektazi 5, pnömoni 5 ve yara yeri enfeksiyonu 2 hastada görüldü. Postoperatif komplikasyonlar ile postoperatif WBC (0,001), preoperatif ve postoperatif hemoglobin (0,006 ve 0,021), preoperatif Nötrofil (0,003), preoperatif ve postoperatif NLO (0,008 ve 0,009) arasında istatistiksel olarak anlamlı ilişki saptandı. Postoperatif komplikasyonlar ile preoperatif WBC, postoperatif nötrofil, preoperatif ve postoperatif lenfosit, preoperatif ve postoperatif monosit, preoperatif ve postoperatif platelet, preoperatif ve postoperatif PLO arasında istatistiksel olarak anlamlı ilişki saptanmadı. Sonuçlar: Videotorakoskopik wedge rezeksiyon yapılan hastalarda postoperatif komplikasyonlar ile yüksek postoperatif WBC, düşük preoperatif ve postoperatif hemoglobin ve yüksek preoperatif ve postoperatif NLO arasında anlamlı ilişki vardır. Postoperatif komplikasyon gelişimini önlemek açısından bu parametrelerin göz önünde bulunması gerekir.

Anahtar Kelimeler:

Postoperatif komplikasyon, Nötrofil/lenfosit oranı, Platelet/lenfosit oranı

The importance of neutrophil/lymphocyte and platelet/lymphocyte ratios in predicting postoperative complications in patients undergoing video thoracoscopic wedge resection

Aim: Postoperative complication is an important factor that prolongs intensive care unit and hospital stay and increases hospital cost. Systemic inflammation is an important risk factor for the occurrence of these complications. In this study, our aim is to reveal the predictive importance of Neutrophil / Lymphocyte Ratio (NLR) and Platelet / Lymphocyte Ratio (PLR) in postopertive complications in patients undergoing videothoracoscopic wedge resection. Material and Method: 122 patients who underwent videothoracoscopic wedge resection due to interstitial lung disease between January 2010 and December 2019 were retrospectively analyzed. Age, gender, smoking history, concomitant diseases, surgical procedure, postoperative complications, preoperative and postoperative WBC, hemoglobin, neutrophil, lymphocyte, monocyte, platelet, NLR and PLR values were obtained from the files. Patients who developed postoperative complications were considered as group 1, while those without complications were classified as group 2. A statistically significant relationship was checked between postoperative complications and laboratory findings. Results: Postoperative complications developed in 18 (14%) patients. Prolonged air leak occurred in 6, atelectasis in 5, pneumonia in 5, and wound infection in 2 patients. There was a statistically significant relationship between postoperative complications and postoperative WBC (0.001), preoperative and postoperative hemoglabin (0.006 and 0.021), preoperative Neutrophil (0.003), preoperative and postoperative NLR (0.008 and 0.009). There was no statistically significant relationship between postoperative complications and preoperative WBC, postoperative neutrophil, preoperative and postoperative lymphocyte, preoperative and postoperative monocyte, preoperative and postoperative platelet, preoperative and postoperative PLR. Conclusion: There is a significant relationship between postoperative complications and high postoperative WBC, low preoperative and postoperative hemoglobin, and high preoperative and postoperative NLR in patients undergoing videothoracoscopic wedge resection. These parameters should be considered in order to prevent postoperative complication development.

Keywords:

Postoperative complication, Neutrophil/lympocyte ratios, Platelet/lymphocyte ratios,

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1. Gasparyan AY, Stavropoulos-Kalinoglou A, Mikhailidis DP, Douglas KM, Kitas GD. Platelet function in rheumatoid arthritis: arthritic and cardio¬vascular implications. Rheumatol Int 2011; 31: 153-64.
2. Olumuyiwa-Akeredolu OO and Pretorius E. Rheumatoid arthritis: nota¬ble biomarkers linking to chronic systemic conditions and cancer. Curr Pharm Des 2016; 22: 918-24.
3. Scherlinger M, Guillotin V, Truchetet ME, Contin-Bordes C, Sisirak V, Duffau P, et al. Systemic lupus erythematosus and systemic sclerosis: all roads lead to platelets. Autoimmun Rev 2018; 17: 625-35.
4. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-α therapy. Rheumatol Int 2010; 30: 1125-9.
5. Abdel Galil SM, Edrees AM, Ajeeb AK, Aldoobi GS, El-Boshy M, Hus¬sain W. Prognostic significance of platelet count in SLE patients. Plate¬lets 2017; 28: 203-7.
6. Lood C, Tydén H, Gullstrand B, Nielsen CT, Heegaard NHH, Linge P, et al. Decreased platelet size is associated with platelet activation and anti-phospholipid syndrome in systemic lupus erythematosus. Rheu¬matol Oxf Engl 2017; 56: 408-16.
7. Gusdon AM, Gialdini G, Kone G, et al. Neutrophil-lymphocyte ratio and perihematomal edema growth in intracerebral hemorrhage. Stroke 2017; 48: 2589–92.
8. Tang Y, Li G, Wu S, et al. Programmed death ligand 1 expression in esophageal cancer following definitive chemoradiotherapy: prognostic significance and association with inflammatory biomarkers. Oncol Lett 2018; 15: 4988–96.
9. Chechlinska M, Kowalewska M, Nowak R. Systemic inflammation as a confounding factor in cancer biomarker discovery and validation. Nat Rev Cancer 2010; 10: 2–3.
10. Chang Y, An H, Xu L, et al. Systemic inflammation score predicts postoperative prognosis of patients with clear-cell renal cell carcinoma. Br J Cancer 2015; 113: 626–633.
11. Suzuki Y, Okabayashi K, Hasegawa H, et al. Comparison of preoperative inflammation-based prognostic scores in patients with colorectal cancer. Ann Surg 2018; 267: 527–531.
12. Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause‐specific mortality and coronary heart disease: The NHANES‐I epidemiologic follow‐up study. Ann Epidemiol 2005; 15: 266–71.
13. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45: 1638–43.
14. Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003; 89: 1200–4.
15. Sato B, Kanda M, Tanaka C, et al. Significance of preoperative systemic inflammation score in short-term and long-term outcomes of patients with pathological T2-4 gastric cancer after radical gastrectomy. World J Surg 2018; 42: 3277–3285.
16. Li S, Wang Z, Zhang W, Li J, Zhou K, Che G. Systemic inflammation score: a novel risk stratification tool for postoperative outcomes after video-assisted thoracoscopic surgery lobectomy for early-stage non-small-cell lung cancer. Cancer Manag Res 2019; 11: 5613-5628.
17. Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The Platelet-to-Lymphocyte Ratio as an Inflammatory Marker in Rheumatic Diseases. Ann Lab Med 2019; 39: 345-357.
18. Balta S, Ozturk C. The platelet‐lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets 2015; 26: 680–1.