Is preoperative spirometry a predictive marker for postoperative complications after colorectal cancer surgery?

Tajima, Yuki; Tsuruta, Masashi; Yahagi, Masashi; Hasegawa, Hirotoshi; Okabayashi, Koji; Shigeta, Kohei; Ishida, Takashi; Kitagawa, Yuko

doi:10.1093/jjco/hyx082

Cited by 20 publications

(19 citation statements)

References 13 publications

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“…There have been some reports which favour the use of spirometry as a preoperative test, particularly in patients undergoing surgeries such as laparoscopic abdominal, open colorectal or bariatric surgery. [26][27][28] Contrastingly, there is evidence to suggest that spirometry is not a good predictor of perioperative pulmonary complications in patients undergoing laparoscopic gastric surgery. 29 There is a recommendation that preoperative spirometry should be reserved for patients with pre-existing respiratory symptoms or risk factors, such as smoking or dyspnoea.…”

Section: Discussionmentioning

confidence: 99%

“…The value of preoperative spirometry testing is also controversial. There have been some reports which favour the use of spirometry as a preoperative test, particularly in patients undergoing surgeries such as laparoscopic abdominal, open colorectal or bariatric surgery . Contrastingly, there is evidence to suggest that spirometry is not a good predictor of perioperative pulmonary complications in patients undergoing laparoscopic gastric surgery .…”

Section: Discussionmentioning

confidence: 99%

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Preoperative cardiac and respiratory investigations do not predict cardio‐respiratory complications after pancreatectomy

Ashrafizadeh

Mehta

Nahm

et al. 2019

ANZ Journal of Surgery

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Background The process of undergoing a pancreatic resection places a patient under notable physiologic strain throughout the perioperative journey, with well recognized risks of postoperative cardiopulmonary complications. Preoperative preparations and screening often incorporate a barrage of testing, including electrocardiograms, transthoracic echocardiography, chest X‐rays and spirometric evaluations. However, the current literature does not demonstrate whether these common tests provide any predictive correlation with postoperative cardiopulmonary complications. This retrospective study is structured to identify complications in post‐pancreatic resection patients and assess for a predictive correlation with preoperative test results. Methods A retrospective analysis of all patients having undergone a pancreatic resection at a single tertiary centre, between 2014 and 2016. The inpatient medical records were reviewed for 30‐day postoperative complications, including acute myocardial infarction, cardiac dysrhythmia, pulmonary embolism, pneumonia or pleural effusions. The results of routine preoperative diagnostic tests and complication rates were analysed. Results A total of 244 patients, median age of 66 years (range 18–88 years) were included in the study. Of these, 11 patients experienced a cardiac complication and 16 patients experienced a respiratory complication. Among those who experienced cardiac events, only two patients had abnormalities in their preoperative electrocardiograms. Patients who sustained a cardiac or respiratory event did not have any evidence of abnormality in their preoperative transthoracic echocardiography or respiratory investigations, respectively. Conclusion Despite the recommendation that high‐risk procedures such as pancreatic resections warrant thorough, routine, preoperative cardiac and respiratory investigation, a more functional preoperative assessment should be considered to stratify and predict postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative cardiac and respiratory investigations do not predict cardio‐respiratory complications after pancreatectomy

Ashrafizadeh

Mehta

Nahm

et al. 2019

ANZ Journal of Surgery

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“…Decreases in %VC postoperatively in patients who have preoperative restrictive impairment suggest that the patient may have developed a severe pulmonary complication 18 , particularly if atelectasis occurs due to suppressed deep breathing from pain 19 . Tajima et al 21 reported %VC may be a predictor of postoperative complications, especially pneumonia in colorectal cancer surgery.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Dysfunction Function and Poor Nutritional Status are Risk Factors for Remote Infections Following Surgery for Colorectal Cancer

et al. 2018

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Objective:We evaluated the preoperative patient status including nutrition, immunity, and inflammation as a predictive factor of remote infection (RI) in colorectal cancer surgery. Subjects and Methods:A total of 351 patients who underwent colorectal cancer resection were retrospectively analyzed. Factors correlated with RI incidence were identified by logistic analysis and stepwise selection.Results: RI occurred in 27 patients, with an incidence of 7.7%. In univariate logistic analysis, a significantly high incidence of RI was associated with excessive blood loss (>423 mL), long duration of surgery (>279 minutes), ileus, pulmonary dysfunction, performance status (PS)"1, American Society of Anesthesiologists (ASA) classification>2, prognostic nutritional index (PNI)!40, and controlling nutritional status (CONUT)"2 , modified Glasgow Prognostic Score (mGPS) (Score 2). In multivariate analysis, pulmonary dysfunction (odds ratio=2.83; 95% CI: 1.14 6.97; p=0.02) and PNI!40 (odds ratio=3.87; 95% CI: 1.45 10.31; p=0.006) were independent risk factors of RI incidence.Conclusion: RI is caused by poor nutrition, immune system dysfunction and pulmonary dysfunction. (J Nippon Med Sch 2018; 85: 208 214)

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“…Regarding the characteristics of individual remote infections in colorectal surgery, AAD occurs primarily as a Clostridioides difficile infection of the gastrointestinal tract, and among gastrointestinal surgeries, the incidence is reported to be higher after colorectal surgery. [17][18][19][20][21][22] Yamamoto et al 21 RTI in colorectal surgery is a risk factor for operative mortality. 16 Previous studies have examined the relationships between RTI incidence and the associated risk factors in colorectal surgery, 6,22,23 and RTI incidence is reported as 2.9% 6 , 5.2% 22 , and 6.2% 23 .…”

Section: Discussionmentioning

confidence: 99%

Postoperative Infection after Colorectal Surgery: Subanalysis of Data from the 2015 Japan Postoperative Infectious Complications Survey

Maruyama

Kusachi²,

Makino

et al. 2020

J Nippon Med Sch

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Background: Most surveillance programs for postoperative infection focus on surgical site infections (SSI). However, remote infections, as postoperative infections, are of emerging clinical importance. We investigated the incidence of both SSI and remote infection following colorectal surgery by performing a subanalysis of a multicenter survey after gastrointestinal surgery. Methods: From September 2015 to March 2016, 1724 patients underwent colorectal surgery in 28 affiliated institutions in Japan. We retrospectively recorded patients' age, sex, surgical site, surgical approach, wound classification, performance status at discharge, and postoperative infection status. Results: Postoperative infections occurred in 236 (13.7%) patients; 150 and 86 patients underwent colon and rectal surgeries (postoperative infection incidence: 13.7% and 14.8%), respectively. Laparoscopic surgery was associated with a significantly lower incidence of postoperative infection compared with open surgery for both colon and rectal surgery (p < 0.001). Among all patients with postoperative infections, 211 (89.4%) had single infections, and 25 (10.6%) had multiple infections. SSI and remote infection in patients with single postoperative infections occurred in 143 (60.6%) and 68 (28.8%) patients, respectively. The most common multiple postoperative infections 3 were "incisional and organ/space SSIs", and "organ/space SSI and bacteremia of unknown origin", with three cases each. Conclusions: This study revealed the distribution of the overall prevalence of postoperative infections, including both SSI and remote infections. Considering the substantial influence of remote infections on patients' quality of life and the social burden, prospective periodic surveillance for both SSI and remote infection is necessary for detailed evaluation and prevention.

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Is preoperative spirometry a predictive marker for postoperative complications after colorectal cancer surgery?

Abstract: In CRC surgery, %VC may be a predictor of postoperative complications, especially pneumonia.

Cited by 20 publications

References 13 publications

Preoperative cardiac and respiratory investigations do not predict cardio‐respiratory complications after pancreatectomy

Preoperative cardiac and respiratory investigations do not predict cardio‐respiratory complications after pancreatectomy

Pulmonary Dysfunction Function and Poor Nutritional Status are Risk Factors for Remote Infections Following Surgery for Colorectal Cancer

Postoperative Infection after Colorectal Surgery: Subanalysis of Data from the 2015 Japan Postoperative Infectious Complications Survey

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