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

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Version: Final published version
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Serval ID
serval:BIB_472DC35B0F70
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predicting primary postoperative pulmonary complications in patients undergoing minimally invasive surgery for colorectal cancer.
Journal
Updates in surgery
Author(s)
Abd El Aziz M.A., Perry W.R., Grass F., Mathis K.L., Larson D.W., Mandrekar J., Behm K.T.
ISSN
2038-3312 (Electronic)
ISSN-L
2038-131X
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
72
Number
4
Pages
977-983
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
The ACS-NSQIP <sup>®</sup> 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.
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 (c statistics = 0.757). Internal validation achieved similar discrimination (c statistics = 0.798).
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.
Keywords
Aged, Aged, 80 and over, Colorectal Neoplasms/surgery, Digestive System Surgical Procedures/adverse effects, Digestive System Surgical Procedures/methods, Female, Forecasting, Heart Failure, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures/adverse effects, Minimally Invasive Surgical Procedures/methods, Pneumonia/epidemiology, Pneumonia/etiology, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Pulmonary Disease, Chronic Obstructive, Risk, Smoking, Colorectal cancer, Colorectal surgery, Failure to wean from mechanical ventilation, Minimally invasive surgery, Pneumonia, Respiratory complications, Unplanned intubation
Pubmed
Web of science
Open Access
Yes
Create date
05/11/2021 11:37
Last modification date
22/01/2022 8:09
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