Abstract
To determine whether the incidence of postoperative pulmonary complications increases in patients with high peak airway pressure (≥30 cm H2O) during laparoscopic colectomy, we investigated consecutive patients with colorectal cancer who had undergone laparoscopic colectomy. Of the 115 enrolled patients, 34 patients (30%) had peak airway pressure ≥30 cm H2O (an overload group). Compared with a nonoverload group (peak airway pressure <30 cm H2O), the overload group had a 5-fold greater incidence of postoperative respiratory complications and operations of longer duration, longer postanesthesia care unit stays, greater alveolar-arterial O2 differences, greater alveolar dead space-to-tidal volume ratios, and lower PaO2 measurements. Body mass index and preoperative alveolar-arterial O2 difference significantly affect higher peak airway pressure occurring during laparoscopic colectomy. Patients who had peak airway pressures ≥30 cm H2O during laparoscopic colectomy for colorectal cancer had higher incidence of postoperative respiratory complications than those whose peak airway pressures remained <30 cm H2O.
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