• Miho Akabane, Shuichiro Matoba, Takatsugu Fujii, Kosuke Hiramatsu, Naoto Okazaki, Yutaka Hanaoka, Shigeo Toda, and Hiroya Kuroyanagi.
• Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
• ANZ J Surg. 2021 Apr 1; 91 (4): E203-E207.

BackgroundWe examined the safety of laparoscopic surgery for colorectal cancer (CRC) in patients with pulmonary dysfunction, and evaluated risk factors (RF) for post-operative complications.MethodsWe defined pulmonary dysfunction as having any diagnosed pulmonary disease with spirometry findings of obstructive or restrictive defects. Clinicopathological factors of 213 patients with pulmonary dysfunction who underwent laparoscopic surgery for CRC at Toranomon Hospital from 1999 to 2016 were evaluated to retrospectively identify RFs for any post-operative complications and major complications, namely post-operative pulmonary complications (PPCs). Examined preoperative factors included age, gender, body mass index, tumour location, smoking history, percentage vital capacity (%VC), forced expiratory volume in 1 s (FEV1.0), a ratio of FEV1.0 to forced vital capacity and American Society of Anesthesiologists physical status grade. Intraoperative factors, such as operative time, blood loss and blood transfusion, were also assessed.ResultsForty patients (18.8%) developed any complications including PPCs. Multivariate analysis revealed that male, rectal cancer and spirometry findings (both low FEV1.0 (0.8 L) and low %VC (<95)) were RFs (P = 0.026, 0.003 and 0.007, respectively). Six cases (2.8%) developed PPCs. The prevalence of PPCs was higher in patients with both low %VC (<95%) and low FEV1.0 (<0.8 L), with statistical significance (P = 0.006).ConclusionOur study suggested that not only low FEV1.0 but also low %VC was an important RF for post-operative complications after laparoscopic surgery for CRC.© 2021 Royal Australasian College of Surgeons.

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