P1.144. Preoperative Biochemical and Micronutrient Abnormalities in Oesophagogastric Surgery

Abstract

Abstract Topic Esophageal Cancer: Other Background Preoperative micronutrient and biochemical abnormalities are common in patients undergoing oesophagogastric surgery. Routine laboratory panels are frequently ordered indiscriminately despite variable diagnostic yield, and the frequency of specific abnormalities according to underlying pathology remains poorly defined. This study aimed to characterise the frequency and pattern of laboratory derangements across benign and malignant oesophagogastric surgical populations to inform more targeted and cost conscious preoperative testing strategies. Methods A single surgeon series was conducted of 78 patients undergoing oesophagogastric operations for benign and malignant indications between 2018 and 2025 in a high volume unit. Preoperative biochemical, haematological, and micronutrient parameters were analysed. Frequencies of abnormal results were calculated for the overall cohort and stratified by pathology, with comparisons between benign and malignant groups performed using chi square testing in SPSS version 31.0.1.0. Results Across the overall cohort, the most frequent abnormalities were creatinine 29/76 (38%), urea 25/76 (33%), haemoglobin 19/74 (26%), mean corpuscular haemoglobin 12/64 (19%), copper 13/27 (48%), and ceruloplasmin 12/27 (44%). Electrolyte abnormalities were uncommon, including sodium 4/76 (5%) and potassium 4/76 (5%). In malignant disease, the most frequent abnormalities were creatinine 17/46 (37%), haemoglobin 13/45 (29%), urea 12/46 (26%), and mean corpuscular haemoglobin 7/39 (18%). In benign disease, abnormalities were most common for urea 13/30 (43%), creatinine 12/30 (40%), copper 8/13 (62%), ceruloplasmin 8/13 (62%), and haemoglobin 6/29 (21%). White cell count, glucose, magnesium, and red cell indices showed similar abnormality frequencies between groups. Several micronutrient tests demonstrated high abnormal proportions within small tested subsets. No statistically significant differences were identified between benign and malignant cohorts. Conclusion Preoperative biochemical abnormalities are frequent in patients undergoing oesophagogastric surgery, particularly involving renal indices, haemoglobin, and trace elements. Although statistical differences between benign and malignant groups were not demonstrated, consistent numerical patterns suggest that certain abnormalities may be anticipated according to underlying pathology, with trace element derangements more frequent in benign disease and anaemia more common in malignant disease. These findings support pathology guided laboratory testing to improve diagnostic yield, minimise unnecessary investigations, and balance cost efficiency with safe perioperative optimisation. Limitations include incomplete micronutrient testing and the retrospective design.