Key result
Chronic respiratory disease is linked to ~3.2-fold higher pulmonary complications after colorectal cancer surgery.
Why the study?
Patients undergoing colorectal surgery for malignancy may be particularly vulnerable to postoperative pulmonary complications due to advanced age, comorbidities, poor nutritional status, and open surgical approaches, prompting an evaluation of their incidence and risk factors.
Observational (n=200)
No
Postoperative pulmonary complications affected 16.0% of patients undergoing colorectal surgery for malignancy, with advanced age, smoking, chronic respiratory disease, ASA physical status >=III, and open surgical approach identified as independent risk factors.
May aid preoperative risk stratification in colorectal cancer surgery; leaves open whether targeted interventions reduce pulmonary complications.
Background: Postoperative pulmonary complications (PPCs) are important causes of morbidity after major abdominal surgery. Patients undergoing colorectal surgery for malignancy may be particularly vulnerable owing to advanced age, smoking, respiratory disease, comorbidities, poor nutritional status, and open surgical approaches. Aim: This study evaluated the incidence and risk factors for PPCs among patients undergoing colorectal surgery for malignancy at Dhaka Medical College Hospital (DMCH). Methods: A prospective observational study included 200 adult patients undergoing colorectal surgery for malignancy at DMCH from January 2024 to December 2025. Demographic, clinical, laboratory, anaesthetic, and operative variables were recorded prospectively. PPCs included pneumonia, treated atelectasis, respiratory failure, pleural effusion requiring intervention, treated bronchospasm, or unplanned postoperative mechanical ventilation. Univariate associations were assessed using appropriate statistical tests. Variables with P<0.10 were entered into multivariable binary logistic regression. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, and ROC analysis assessed model discrimination. Results: Among 200 patients, 32 (16.0%) developed PPCs. Pneumonia occurred in 15 (7.5%), atelectasis in 12 (6.0%), and respiratory failure in 7 (3.5%). PPCs were associated with older age, smoking, chronic respiratory disease, ASA physical status ≥III, hypoalbuminaemia, and open surgery. Multivariable analysis identified age ≥65 years (aOR 2.74, 95% CI 1.17–6.42; P=0.020), smoking (aOR 2.31, 95% CI 1.01–5.30; P=0.047), chronic respiratory disease (aOR 3.21, 95% CI 1.19–8.65; P=0.021), ASA ≥III (aOR 2.86, 95% CI 1.25–6.53; P=0.012), and open surgery (aOR 2.68, 95% CI 1.15–6.24; P=0.022) as independent risk factors. Conclusion: PPCs affected approximately one-sixth of patients. Advanced age, smoking, chronic respiratory disease, higher ASA physical status, and open surgery were independently associated with PPCs. Early risk identification may support targeted respiratory optimization and closer postoperative surveillance.
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Humayra Ahmed Ukti (2026) conducted an observational in Colorectal malignancy requiring surgery (n=200). Clinical and surgical risk factors (chronic respiratory disease, ASA >=III, age >=65, open surgery, smoking) vs. Absence of risk factors was evaluated on Postoperative pulmonary complications (pneumonia, treated atelectasis, respiratory failure, pleural effusion requiring intervention, treated bronchospasm, or unplanned postoperative mechanical ventilation) (aOR 3.21, 95% CI 1.19-8.65, p=0.021). Colorectal cancer surgery resulted in a 16.0% rate of postoperative pulmonary complications, independently predicted by chronic respiratory disease (aOR 3.21), ASA >=III (aOR 2.86), and age >=65.
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