Scholarlink

Background <p>Postoperative pulmonary complications (PPCs) significantly influence clinical outcomes following esophagectomy for esophageal cancer. Identifying reliable preoperative predictors is essential for optimizing surgical outcomes. Although chronic obstructive pulmonary disease (COPD) is an established risk factor, the role of preoperative quantitative emphysema assessment using low-attenuation area percentage (LAA%) on computed tomography (CT) remains unclear. We retrospectively investigated the association of preoperative LAA% with PPCs and postoperative prognosis in patients undergoing thoracic esophagectomy for esophageal cancer.</p> Methods <p>We enrolled 334 patients who underwent esophagectomy for esophageal cancer at Kindai University Hospital between January 2016 and March 2024. Preoperative LAA% was quantified using specialized software, and PPCs were defined as events occurring within 2&#xa0;weeks after esophagectomy and classified according to the Clavien–Dindo classification. The association between bilateral&#xa0;LAA% and PPCs was assessed using logistic regression analyses, while long-term prognosis was evaluated using Kaplan–Meier survival analysis.</p> Results <p>The incidence of PPCs was 32.9% (110/334 patients). Multivariable logistic regression analysis demonstrated that preoperative bilateral LAA% ≥ 5% was significantly associated with an increased risk of PPCs (odds ratio [OR]: 3.81, 95% confidence interval [CI] 1.01–14.4, p = 0.04). Kaplan–Meier survival analysis showed that patients with bilateral LAA% ≥ 5% had significantly lower 5-year&#xa0;overall survival than those with bilateral LAA% &lt; 5% (p = 0.03).</p> Conclusion <p>Preoperative LAA% is a predictor of PPCs and postoperative prognosis after esophagectomy for esophageal cancer. Quantitative CT analysis of emphysema can improve the preoperative risk stratification. Future multicenter studies are needed to validate these results, particularly for minimally invasive esophagectomies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Preoperative low attenuation area percentage as a predictor of postoperative pulmonary complications and prognosis in esophagectomy: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年12月4日

查看全文
  • Hiroki Mizusawa,
  • Osamu Shiraishi,
  • Yuji Higashimoto,
  • Masashi Shiraishi,
  • Masaya Noguchi,
  • Kengo Kanki,
  • Tomomi Tamura,
  • Takushi Yasuda

摘要

Background

Postoperative pulmonary complications (PPCs) significantly influence clinical outcomes following esophagectomy for esophageal cancer. Identifying reliable preoperative predictors is essential for optimizing surgical outcomes. Although chronic obstructive pulmonary disease (COPD) is an established risk factor, the role of preoperative quantitative emphysema assessment using low-attenuation area percentage (LAA%) on computed tomography (CT) remains unclear. We retrospectively investigated the association of preoperative LAA% with PPCs and postoperative prognosis in patients undergoing thoracic esophagectomy for esophageal cancer.

Methods

We enrolled 334 patients who underwent esophagectomy for esophageal cancer at Kindai University Hospital between January 2016 and March 2024. Preoperative LAA% was quantified using specialized software, and PPCs were defined as events occurring within 2 weeks after esophagectomy and classified according to the Clavien–Dindo classification. The association between bilateral LAA% and PPCs was assessed using logistic regression analyses, while long-term prognosis was evaluated using Kaplan–Meier survival analysis.

Results

The incidence of PPCs was 32.9% (110/334 patients). Multivariable logistic regression analysis demonstrated that preoperative bilateral LAA% ≥ 5% was significantly associated with an increased risk of PPCs (odds ratio [OR]: 3.81, 95% confidence interval [CI] 1.01–14.4, p = 0.04). Kaplan–Meier survival analysis showed that patients with bilateral LAA% ≥ 5% had significantly lower 5-year overall survival than those with bilateral LAA% < 5% (p = 0.03).

Conclusion

Preoperative LAA% is a predictor of PPCs and postoperative prognosis after esophagectomy for esophageal cancer. Quantitative CT analysis of emphysema can improve the preoperative risk stratification. Future multicenter studies are needed to validate these results, particularly for minimally invasive esophagectomies.