[Sportschosun Reporter Jang Jong-ho] A study has found that the risk of developing dyslipidemia after surgery for colorectal cancer varies depending on where the operation is performed.
International St. Mary's Hospital, Catholic Kwandong University, said that a research team led by Professor Lee Jae-im of the Department of Surgery published a paper showing that the long-term risk of metabolic diseases may differ depending on the resection site after colorectal cancer surgery.
The paper, titled "Risk of Metabolic Disease After Right- and Left-Sided Colectomy for Colorectal Cancer: A Nationwide Cohort Study," was published online in Diseases of the Colon & Rectum (DCR), the official journal of the American Society of Colon and Rectal Surgeons.
The research team, with Professor Lee Jae-im of the Department of Surgery at International St. Mary's Hospital, Catholic Kwandong University, as corresponding author and clinical instructor Oh Soo-young of the Colorectal Surgery Department at Asan Medical Center as first author, analyzed 8,288 patients who underwent colorectal cancer surgery from 2013 to 2019 using national big data from Korea Central Cancer Registry statistics, NHIS, and health screening records linked through K-CURE.
Among the 8,288 patients analyzed, 3,253 underwent right colectomy and 4,975 underwent left colectomy. The median follow-up period was four years.
During the follow-up period, new cases of metabolic disease were diagnosed in patients who had undergone colorectal cancer surgery, including diabetes (4.4%), hypertension (12.8%), and dyslipidemia (14.2%).
In particular, multivariate analysis showed that patients who underwent right colectomy had about a 20% lower risk of dyslipidemia than those who underwent left colectomy, a statistically significant difference (HR 0.80, 95% CI 0.71-0.91). By contrast, there was no significant difference between the two groups in the risk of diabetes or hypertension.
The research team explained that this may be related to changes in the enterohepatic circulation of bile acids and the intestinal microbial environment, as the right colectomy procedure removes the terminal ileum, the main site of bile acid reabsorption, along with the ileocecal valve, which serves as the boundary between the small and large intestines. These changes may affect cholesterol metabolism and help improve blood lipid levels.
Professor Lee Jae-im said, "It is well known that metabolic syndrome affects the development and prognosis of colorectal cancer, but there has been very little research on how colorectal cancer surgery itself affects the later development of metabolic diseases." He added, "This study is meaningful because it is a large-scale nationwide study showing that postoperative metabolic outcomes may differ depending on the location of colectomy."
He also emphasized, "As the number of colorectal cancer survivors continues to rise, managing metabolic disease is becoming just as important as monitoring for recurrence." He added, "In particular, patients who undergo left colectomy may need regular lipid testing and management of cardiovascular risk factors after surgery."
Meanwhile, the research team plans to conduct follow-up studies to identify the mechanisms behind metabolic changes according to the resection site through future bile acid analyses and gut microbiome research.
Reporter Jang Jong-ho bellho@sportschosun.com
