Incidence and risk factors of postoperative pulmonary complications following esophageal cancer surgery: a single-center retrospective study.

Background: Postoperative pulmonary complications (PPCs) correlate with poor outcomes for patients. The reported frequency of these post-surgical pulmonary complications shows considerable variation among different studies, primarily due to varying definitions and surgical procedures. Our research sought to determine the occurrence rate of PPCs in patients receiving planned esophageal cancer (EC) surgery at Changhai Hospital and to establish the associated risk indicators. Methods: The research involved a retrospective analysis at Shanghai's Changhai Hospital, examining 344 cases of planned EC surgery performed throughout 2021. The study population was categorized into two cohorts: those who developed PPCs (30 subjects) and those who did not (314 subjects). Researchers gathered comprehensive patient information, including demographics, existing health conditions, physiological measurements, and clinical test outcomes. To identify standalone predictors of postoperative pulmonary events, both single-variable and multiple-variable logistic regression models were employed. Results: The aggregate occurrence of PPCs reached approximately 8.7%. The PPC group demonstrated notably elevated rates of mortality during hospitalization, prolonged intensive care unit (ICU) stays, post-surgical anastomotic leakage, and additional surgeries when contrasted with the non-PPC group (all P<0.05). Hospital duration was also considerably longer among PPC patients (P<0.05). Through multivariate regression, several independent risk factors for PPCs were identified: male sex, smoking, diabetes, lung diseases, reduced platelet count (PLT), and elevated neutrophil percentage (NEUT) within the first 24 hours following surgery. Furthermore, a robust correlation exists between PPCs and higher rates of prolonged ICU stays (odds ratio =24.0, 95% confidence interval: 4.2-137.2, P<0.001). This correlation maintained statistical significance after controlling for age, sex, body mass index, smoking, and concurrent medical conditions. Conclusions: Patients undergoing esophageal surgery have a moderate risk of PPCs, which is significantly associated with adverse outcomes after surgery. The risk factors include male sex, smoking, lung diseases, diabetes, a decrease in PLT and an increase in NEUT within 24 hours after surgery.