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Purpose <p>This study aimed to evaluate the predictive performance of the established risk scores for postoperative pulmonary complications and develop a novel integrated score derived from these assessments in older adults undergoing laparoscopic right-sided colectomy. The secondary endpoints included the incidence of pulmonary complications and the factors related to their severity.</p> Methods <p>This dual-center retrospective study included 342 patients (≥ 75&#xa0;years) who underwent laparoscopic right-sided colectomy for colon cancer between 2009 and 2023. The Estimation of Physiologic Ability and Surgical Stress system and the Prognostic Nutritional Index were evaluated as predictors of pulmonary complications (Clavien–Dindo grade ≥ 2). The risk factors were analyzed using logistic regression, from which a novel integrated score was developed, and the predictive performance was evaluated using a receiver operating characteristic curve analysis.</p> Results <p>Pulmonary complications occurred in 13 (3.8%) patients. Multivariate analyses identified the Preoperative Risk Score and Prognostic Nutritional Index as independent predictors. A combination score (Nutritional And Multisystem–Based Assessment [NAMBA] score) incorporating both preoperative assessments accurately identified high-risk patients (area under the curve, 0.801). Pulmonary complications occurring after abdominal complications were associated with their severity.</p> Conclusions <p>The NAMBA score effectively identifies older adults at high risk of pulmonary complications after laparoscopic right-sided colectomy and it may improve perioperative management.</p>

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Development of a novel combination score derived from preoperative risk assessments for predicting postoperative pulmonary complications in older adults undergoing laparoscopic right-sided colon cancer surgery: a dual-center retrospective study

  • 期刊论文

  • 发表日期：

    2026年4月21日

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  • Hiromasa Namba,
  • Ken Imaizumi,
  • Nobuki Ichikawa,
  • Shigenori Homma,
  • Tadashi Yoshida,
  • Sunao Fujiyoshi,
  • Kengo Shibata,
  • Tatsushi Shimokuni,
  • Hiroyuki Kasajima,
  • Kazuaki Nakanishi,
  • Akinobu Taketomi

摘要

Purpose

This study aimed to evaluate the predictive performance of the established risk scores for postoperative pulmonary complications and develop a novel integrated score derived from these assessments in older adults undergoing laparoscopic right-sided colectomy. The secondary endpoints included the incidence of pulmonary complications and the factors related to their severity.

Methods

This dual-center retrospective study included 342 patients (≥ 75 years) who underwent laparoscopic right-sided colectomy for colon cancer between 2009 and 2023. The Estimation of Physiologic Ability and Surgical Stress system and the Prognostic Nutritional Index were evaluated as predictors of pulmonary complications (Clavien–Dindo grade ≥ 2). The risk factors were analyzed using logistic regression, from which a novel integrated score was developed, and the predictive performance was evaluated using a receiver operating characteristic curve analysis.

Results

Pulmonary complications occurred in 13 (3.8%) patients. Multivariate analyses identified the Preoperative Risk Score and Prognostic Nutritional Index as independent predictors. A combination score (Nutritional And Multisystem–Based Assessment [NAMBA] score) incorporating both preoperative assessments accurately identified high-risk patients (area under the curve, 0.801). Pulmonary complications occurring after abdominal complications were associated with their severity.

Conclusions

The NAMBA score effectively identifies older adults at high risk of pulmonary complications after laparoscopic right-sided colectomy and it may improve perioperative management.