Is preoperative spirometry a predictive marker for postoperative complications after colorectal cancer surgery?
Is preoperative spirometry a predictive marker for postoperative complications after colorectal cancer surgery?
复制标题
DOI：
10.1093/jjco/hyx082
复制
发表时间：
2017-09-01
影响因子：
2.4
通讯作者：
Kitagawa, Yuko
中科院分区：
文献类型：
--
作者：
Tajima, Yuki;Tsuruta, Masashi;Kitagawa, Yuko
背景资料：肺功能测定是一项基本检查，可提供有关肺功能的许多信息;在我院几乎所有接受结直肠癌（CRC）手术的患者术前均进行肺功能测定。然而，肺功能测定作为结直肠癌手术术前检查的价值仍然未知。本研究的目的是确定肺功能测定是否有助于预测结直肠癌手术后并发症（PC）after CRC surgery.Methods：回顾了2005年至2014年间1236例术前进行肺功能测定并接受结直肠癌手术的患者的病历。术前肺功能测定结果，如用力肺活量（FVC）、一秒用力呼气量（FEV 1）、% VC（FVC/预测VC）和FEV 1/FVC（%FEV 1）进行了分析，与PC有关，包括肺炎。在383例中发现了PC（30.9%）例患者，包括218例（56%）手术部位感染，67例（17%）肠梗阻，62例（16%）渗漏和20例（5.2%）肺炎。根据Logistic回归分析，肺功能测定结果中，% VC与PC相关（比值比，OR = 0.99，95%可信区间，CI = 0.98-0.99; P = 0.034）。校正男性性别、年龄、腹腔镜手术、肿瘤位置、手术时间和失血量后的多变量分析显示，较低的% VC往往是PC的危险因素（OR = 0.99，95%CI = 0.98-1.002; P = 0.159）和% VC是PCs术后肺炎的独立危险因素结论：% VC可作为结直肠癌术后并发症的预测指标，尤其是肺炎的预测指标。
Background: Spirometry is a basic test that provides much information about pulmonary function; it is performed preoperatively in almost all patients undergoing colorectal cancer (CRC) surgery in our hospital. However, the value of spirometry as a preoperative test for CRC surgery remains unknown. The aim of this study was to determine whether spirometry is useful to predict postoperative complications (PCs) after CRC surgery.Methods: The medical records of 1236 patients who had preoperative spirometry tests and underwent CRC surgery between 2005 and 2014 were reviewed. Preoperative spirometry results, such as forced vital capacity (FVC), one-second forced expiratory volume (FEV1), % VC (FVC/predicted VC) and FEV1/FVC (% FEV1), were analyzed with regard to PCs, including pneumonia.Results: PCs were found in 383 (30.9%) patients, including 218 (56%) with surgical site infections, 67 (17%) with bowel obstruction, 62 (16%) with leakage and 20 (5.2%) with pneumonia. Of the spirometry results, % VC was correlated with PC according to logistic regression analysis (odds ratio, OR = 0.99, 95% confidence interval, CI = 0.98-0.99; P = 0.034). Multivariate analysis after adjusting for male sex, age, laparoscopic surgery, tumor location, operation time and blood loss showed that a lower % VC tends to be a risk factor for PC (OR = 0.99, 95% CI = 0.98-1.002; P = 0.159) and % VC was an independent risk factor for postoperative pneumonia in PCs (OR = 0.97, 95% CI = 0.94-0.99; P = 0.049).Conclusions: In CRC surgery, % VC may be a predictor of postoperative complications, especially pneumonia.