Predictors Of Postoperative Complications In Patients Research Articles

The relationship between aortic calcification, cardiopulmonary function and postoperative complications in patients undergoing colorectal cancer resection

Introduction: The degree of aortic calcification (AC) visible on the preoperative CT and cardiopulmonary exercise test (CPET)-derived measures of fitness have been proposed as predictors of postoperative complications (POC). This study aims to examine the relationship between AC, CPET and POC in patients undergoing CRC resection.

490 The Relationship Between Aortic Calcification Along with Cardiopulmonary Function and Postoperative Complications in Patients Undergoing Colorectal Cancer Resection

Abstract Introduction The degree of aortic calcification (AC) visible on the preoperative CT and cardiopulmonary exercise test (CPET)-derived measures of fitness have been proposed as predictors of postoperative complications (POC). This study aims to examine the relationship between AC, CPET and POC in patients undergoing CRC resection. Method Patients who had undergone CPET prior to CRC resection in a single centre were identified from a prospectively maintained database. Oxygen uptake (VO2) at the anaerobic threshold (AT) and peak exercise were recorded. Visual scoring of AC was performed. POC were recorded as infective and non-infective using the Clavien-Dindo (CD) scale. Results A total of 48 patients were included. AC was more common in older patients. A trend was reported between greater burden of proximal AC and major complications (CD 3-5) while AT < 11 was found to be associated with non-infective complications. No statistically signification association was noted between either AC or CPET variables and POC. Conclusions This study shown possible association between AC or preoperative CPE-derived measures of exercise tolerance and POC after colorectal resection. Relationship between AC and CPET variables was not clearly defined due to small sample size. Further work is warranted to investigate these relationships in a larger cohort.

Impact of comorbidities on postoperative complications in patients undergoing laparoscopy-assisted gastrectomy for gastric cancer.

BackgroundComorbidity is a predictor of postoperative complications (PCs) in gastrectomy. However, it remains unclear which comorbidities are predictors of PCs in patients who undergo laparoscopy-assisted gastrectomy (LAG). Clinically, insufficient lymphadenectomy (LND) is sometimes performed in high-risk patients, although the impact on PCs and outcomes remains unclear.MethodsWe retrospectively studied 529 patients with gastric cancer (GC) who underwent LAG. PCs were defined as grade 2 or higher events according to the Clavien-Dindo classification. We evaluated various comorbidities as risk factors for PCs and examined the impact of insufficient LND on PCs in patients with risky comorbidities.ResultA total of 87 (16.4%) patients had PCs. There was no PC-related death. On univariate analysis, heart disease, central nervous system (CNS) disease, liver disease, renal dysfunction, and restrictive pulmonary dysfunction were significantly associated with PCs. Both liver disease and heart disease were significant independent risk factors for PCs on multivariate analysis (odds ratio [OR] = 3.25, p = 0.022; OR = 2.36, p = 0.017, respectively). In patients with one or more risky comorbidity, insufficient LND did not significantly decrease PCs (p = 0.42) or shorten GC-specific survival (p = 0.25).ConclusionIn patients who undergo LAG for GC, the presence of heart disease or liver disease is an independent risk factor for PC. Insufficient LND (for example, D1+ for advanced GC) might be permissible in high-risk patients, because although it did not reduce PCs, it had no negative impact on GC-specific survival.