Predicting primary postoperative pulmonary complications in patients undergoing minimally invasive surgery for colorectal cancer

被引:8
作者
Abd El Aziz, Mohamed A. [1 ]
Perry, William R. [1 ]
Grass, Fabian [1 ]
Mathis, Kellie L. [1 ]
Larson, David W. [1 ]
Mandrekar, Jay [2 ]
Behm, Kevin T. [1 ]
机构
[1] Mayo Clin, Dept Surg, Div Colon & Rectal Surg, 200 First St Southwest, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Hlth Sci Res, Rochester, MN USA
关键词
Colorectal surgery; Minimally invasive surgery; Colorectal cancer; Respiratory complications; Pneumonia; Unplanned intubation; Failure to wean from mechanical ventilation; ENHANCED RECOVERY; RISK CALCULATOR; METAANALYSIS; VALIDATION; SYSTEM;
D O I
10.1007/s13304-020-00892-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective To determine the risk factors for developing primary postoperative pulmonary complications (PPC) in patients undergoing minimally invasive colorectal surgery (MIS) for the treatment of cancer and to identify the potential indicators for more extensive preoperative evaluation. Materials and methods The ACS-NSQIP(R)database was interrogated to capture patients who had elective colon or rectal cancer and underwent MIS between 2012 and 2017. Patients who had primary PPC including pneumonia, unplanned intubation and/or failure to wean from mechanical ventilation for > 48 h were compared to patients without PPC. Significant risk factors for PPC were retained to build a predictive risk model through logistic regression analysis. The model was then internally validated using 2018 data. Results Of 50,150 patients identified, 637 (1.3%) had PPC. The final risk prediction model included six variables: history of chronic obstructive pulmonary disease, age, smoking status, functional health status, pre-operative congestive heart failure, and American Society of Anesthesiology class >= 3. The model achieved good calibration (Hosmer-Lemeshow goodness-of-fit test,p = 0.614) and discrimination (cstatistics = 0.757). Internal validation achieved similar discrimination (cstatistics = 0.798). Conclusion Primary postoperative pulmonary complications affected 1.3% of patients undergoing MIS for colon or rectal cancer. The novel predictive risk score showed good discrimination and may help to identify patients who may benefit from perioperative optimization.
引用
收藏
页码:977 / 983
页数:7
相关论文
共 32 条
[1]   Colectomy for patients with super obesity: current practice and surgical morbidity in the United States [J].
Abd El Aziz, Mohamed A. ;
Grass, Fabian ;
Perry, William ;
Behm, Kevin T. ;
Shawki, Sherief F. ;
Larson, David W. ;
Mathis, Kellie L. .
SURGERY FOR OBESITY AND RELATED DISEASES, 2020, 16 (11) :1764-1769
[2]   Trends of complications and innovative techniques' utilization for colectomies in the United States [J].
Abd El Aziz, Mohamed A. ;
Grass, Fabian ;
Behm, Kevin T. ;
Shawki, Sherief ;
D'Angelo, Anne-Lise ;
Mathis, Kellie L. ;
Larson, David W. .
UPDATES IN SURGERY, 2021, 73 (01) :101-110
[3]   Laparoscopic versus Open Obesity Surgery: A Meta-Analysis of Pulmonary Complications [J].
Antoniou, Stavros Athanasios ;
Antoniou, George Athanasios ;
Koch, Oliver Owen ;
Koehler, Gernot ;
Pointner, Rudolph ;
Granderath, Frank-Alexander .
DIGESTIVE SURGERY, 2015, 32 (02) :98-107
[4]   Multifactorial risk index for predicting postoperative respiratory failure in men after major noncardiac surgery [J].
Arozullah, AM ;
Daley, J ;
Henderson, WG ;
Khuri, SF .
ANNALS OF SURGERY, 2000, 232 (02) :242-253
[5]   Effects of laparoscopic cholecystectomy on lung function: A systematic review [J].
Bablekos, George D. ;
Michaelides, Stylianos A. ;
Analitis, Antonis ;
Charalabopoulos, Konstantinos A. .
WORLD JOURNAL OF GASTROENTEROLOGY, 2014, 20 (46) :17603-17617
[6]   COPD is a clear risk factor for increased use of resources and adverse outcomes in patients undergoing intervention for colorectal cancer: a nationwide study in Spain [J].
Bare, Marisa ;
Monton, Concepcion ;
Mora, Laura ;
Redondo, Maximino ;
Pont, Marina ;
Escobar, Antonio ;
Sarasqueta, Cristina ;
Fernandez de Larrea, Nerea ;
Briones, Eduardo ;
Maria Quintana, Jose .
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2017, 12 :1233-1241
[7]   Preoperative and Intraoperative Predictors of Postoperative Acute Respiratory Distress Syndrome in a General Surgical Population [J].
Blum, James M. ;
Stentz, Michael J. ;
Dechert, Ronald ;
Jewell, Elizabeth ;
Engoren, Milo ;
Rosenberg, Andrew L. ;
Park, Pauline K. .
ANESTHESIOLOGY, 2013, 118 (01) :19-29
[8]  
Canet J., 2015, EUR J ANAESTH, V32, P458
[9]   Prediction of Postoperative Pulmonary Complications in a Population-based Surgical Cohort [J].
Canet, Jaume ;
Gallart, Lluis ;
Gomar, Carmen ;
Paluzie, Guillem ;
Valles, Jordi ;
Castillo, Jordi ;
Sabate, Sergi ;
Mazo, Valentin ;
Briones, Zahara ;
Sanchis, Joaquin .
ANESTHESIOLOGY, 2010, 113 (06) :1338-1350
[10]   Enhanced Recovery Program in Colorectal Surgery: A Meta-analysis of Randomized Controlled Trials [J].
Greco, Massimiliano ;
Capretti, Giovanni ;
Beretta, Luigi ;
Gemma, Marco ;
Pecorelli, Nicolo ;
Braga, Marco .
WORLD JOURNAL OF SURGERY, 2014, 38 (06) :1531-1541