Respiratory Complications After Colorectal Surgery: Avoidable or Fate?

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2018 Jun 22

PMID 29926123

Citations 8

Authors

Jonas Jurt

Martin Hubner

Basile Pache

Dieter Hahnloser

Nicolas Demartines

Fabian Grass

Affiliations

Soon will be listed here.

Abstract

Background: The prevention of post-operative pulmonary complications (PPC) is targeted by several enhanced recovery (ERAS) items including early mobilisation, prevention of fluid overload and omission of routine nasogastric tubes. The aim of the present study was to assess the impact of ERAS on PPC.

Methods: This was a retrospective analysis of an institutional database including consecutive colorectal ERAS procedures from May 2011 until May 2017. Multiple logistic regressions were performed to identify risk factors for PPC among demographic, surgical characteristics and items related to the ERAS protocol.

Results: In total, 1298 patients were included; among them 120 (9.2%) had one or more PPC. Multivariable analysis retained minimally invasive surgery [odds ratio (OR) 0.26; 95% confidence interval (CI) 0.15-0.46] and compliance to the ERAS protocol of ≥ 70% (OR 0.53; CI 0.30-0.94) as protective factors. Emergency surgery (OR 2.70; CI 1.20-6.01), blood loss of ≥ 200 mL (OR 2.06; CI 1.20-3.53) and ASA score of ≥ 3 (OR 2.00; CI 1.12-3.57) were independent risk factors. Median length of hospital stay was significantly longer in patients who experienced respiratory complications (21 [4-183] vs. 6 [1-95] days, p ≤ 0.001).

Conclusions: Minimally invasive surgery and high compliance with the ERAS protocol can help to prevent PPC.

Citing Articles

Analyzing postoperative complications in colorectal cancer surgery: a systematic review enhanced by artificial intelligence.

Andras D, Lazar A, Cretoiu D, Berghea F, Georgescu D, Grigorean V Front Surg. 2024; 11:1452223.

PMID: 39544841 PMC: 11560852. DOI: 10.3389/fsurg.2024.1452223.

Respiratory Complications after Cystectomy with Urinary Diversion: Avoidable Complications or Ineluctable Destiny?.

Martinez Carrique S, Crettenand F, Stritt K, Bohner P, Grilo N, Rodrigues-Dias S J Clin Med. 2024; 13(6).

PMID: 38541810 PMC: 10971594. DOI: 10.3390/jcm13061585.

Perioperative Fluid Management in Colorectal Surgery: Institutional Approach to Standardized Practice.

Deslarzes P, Jurt J, Larson D, Blanc C, Hubner M, Grass F J Clin Med. 2024; 13(3).

PMID: 38337495 PMC: 10856154. DOI: 10.3390/jcm13030801.

Early intensive mobilization after acute high-risk abdominal surgery: a nonrandomized prospective feasibility trial.

Jonsson L, Foss N, Orbaek J, Lauritsen M, Sejrsen H, Kristensen M Can J Surg. 2023; 66(3):E236-E245.

PMID: 37130709 PMC: 10158751. DOI: 10.1503/cjs.008722.

Appropriate time to radical surgery for colorectal cancer patients complicated with newly onset cerebral infarction: a propensity score matching analysis.

Dou W, Liu T, Zheng H, Feng S, Wu Y, Wang X Sci Rep. 2023; 13(1):4790.

PMID: 36959256 PMC: 10036373. DOI: 10.1038/s41598-023-31988-9.

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