Does testosterone prevent early postoperative complications after gastrointestinal surgery?

Table 1 Demographic data of the patients

Details	Frequency
Age group (yr)
≤ 60	32
61–70	19
≥ 71	14
Sex
Male	42
Female	23
No. of procedures
Gastrectomy	49
Colorectal resection1	9
Gastro-jejunal anastomosis	2
Exploratory laparotomy	5
TNM classification (Gastric cancer)
IA	8
IB	6
II	7
IIIA	10
IIIB	4
IV	12
Dukes classification (Colorectal)
A	7
B	0
C	1

¹Including one case of small bowel resection combined with mesenteric tumor.

Table 2 Overall complications in both sexes

Complications	Frequency
	Male	Female
Overall	9	11
Intra-abdominal hemorrhage	1	0
Anastomotic leak	1	1
Abdominal infection	2	1
Pyrexia of unknown origin	7	9
Renal failure	1	0
Respiratory failure	0	1
Cardiac failure	0	1
Hypotension	0	1
MODS	0	1
Gastroplegia or enteroplegia	0	2
Anastomosis site bleeding	1	1
Pleural effusion	0	2
Seroperitoneum	2	1
Death	0	1

MODS: Multiple organ dysfunction syndrome.

Table 3 Normal range of different hormones

	Male	Female (postmenopause)
Estradiol (pg/mL)	20-75	20-88
Progesterone (ng/mL)	0.1-0.84	0.08-0.78
Testosterone (ng/mL)	2.62-15.9	0.1-0.8

Table 4 Demographics and clinical characteristics according to sex

	Male (n = 42)	Female (n = 23)	P value
Age (yr)	60.9	58.1	0.356
Physiological score	14	17	0.203
Operative severity score	16	18	0.365
Complications (%)	21.4	47.8	0.027
Baseline estradiol (pg/mL)	23	12	0.320
Baseline progesterone (ng/mL)	0.46	0.37	0.450
Baseline testosterone (ng/mL)	3.26	0.23	0.000

Table 5 Significance of difference in testosterone level at different times

Complication	Baseline	POD1	POD3	POD5	POD7
Overall	0.008	0.002	0.007	0.001	0.000
Gastric disease	0.025	0.008	0.026	0.005	0.005

Table 6 Level of testosterone in different sexes according to outcome

Time	Complications (male)			Complications (female)
	Absent	Present	P value	Absent	Present	P value
Base	3.66	2.74	0.104	0.23	0.29	0.689
POD1	0.91	0.87	0.141	0.40	0.23	0.268
POD3	1.54	0.85	0.046	0.19	0.20	0.948
POD5	2.20	0.91	0.040	0.41	0.21	0.038
POD7	3.22	1.24	0.030	0.38	0.16	0.007

Table 7 Area under the ROC for testosterone

Time	Area	P value	95% CI
			Lower bound	Upper bound
BASE	0.729	0.016	0.562	0.897
POD1	0.801	0.002	0.658	0.945
POD3	0.756	0.007	0.593	0.919
POD5	0.813	0.001	0.664	0.963
POD7	0.835	0.000	0.692	0.977

Table 8 Sensitivity and specificity for different levels of testosterone

	Testosterone level	Sensitivity	Specificity
Base	≤ 1.95	70.0	68.9
POD1	≤ 0.43	60.0	84.4
POD3	≤ 0.45	73.3	80.0
POD5	≤ 0.24	60.0	90.0
POD7	≤ 0.32	66.7	92.0