Factors Affecting Pulmonary Complications after Combined Thoracolaparoscopic Radical Esophagectomy for Esophageal Cancer in Elderly Patients

医学 食管切除术 食管癌 单变量分析 心胸外科 根治性手术 外科 肺功能测试 入射(几何) 糖尿病 阶段(地层学) 癌症 内科学 多元分析 古生物学 物理 光学 生物 内分泌学
作者
Chen Hong-xing,Mingdu Dong,Yusheng Xu,Dongchun Ma
出处
期刊:JCPSP. Journal of the College of Physicians & Surgeons Pakistan [College of Physicians and Surgeons Pakistan]
卷期号:33 (04): 433-437
标识
DOI:10.29271/jcpsp.2023.04.433
摘要

To determine the frequency and risk factors for pulmonary complications in elderly patients undergoing combined thoracolaparoscopic radical esophageal cancer surgery, and to develop a predictive model for pulmonary complications occurrence.Observational study. Place and Duration of the Study: Department of Thoracic Surgery, Lujiang County People's Hospital, Anhui Province, China, from January 2017 to August 2022.Two hundred and sixty elderly patients who underwent combined thoracic and laparoscopic radical esophagectomy were included. Univariate and multifactorial analyses were performed to identify risk factors for pulmonary complications, and a predictive model was developed using significant factors.Pulmonary complications occurred in 27.69% of patients. Advanced age, smoking index, diabetes mellitus, tumour location, advanced clinical stage, intraoperative bleeding, duration of operation, and postoperative mechanical ventilation time were significantly associated with pulmonary complications (p<0.05). Multifactorial analysis identified advanced age, diabetes, smoking index, advanced clinical stage, and time of surgery as independent risk factors for pulmonary complications. The prediction model had good predictive efficacy with an area under the ROC curve of 0.857, sensitivity of 83.3%, and specificity of 71.1%.Combined thoracolaparoscopic radical esophageal cancer surgery has a high incidence of pulmonary complications in elderly patients. Advanced age, diabetes, smoking index, advanced clinical stage, and time of surgery are independent risk factors for pulmonary complications, and the developed predictive model will be contributing to identify high-risk patients.Esophageal cancer, Elderly patients, Pulmonary complications, Risk factors.
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