Published online Dec 15, 2026. doi: 10.4251/wjgo.124694
Revised: August 10, 2026
Accepted: September 17, 2026
Published online: December 15, 2026
Processing time: 132 Days and 3.1 Hours
Postoperative pulmonary complications (PPCs) are a major cause of morbidity after abdominal surgery. However, the risk factors associated with laparoscopic radical resection for colorectal cancer (LRCRC) remain unclear.
To investigate the independent risk factors for PPCs following LRCRC and develop a risk prediction model with robust predictive performance.
Data of 251 patients who underwent LRCRC at our hospital between December 2020 and December 2025 were retrospectively analyzed. Patients were categorized into PPC (n = 70) and non-PPC (n = 181) groups based on the occurrence of PPCs within 30 days postoperatively. Univariate analysis was performed to screen for variables with significant intergroup differences, which were subsequently included in multivariate logistic regression analysis. Receiver operating characteristic curves were generated to evaluate the predictive performance of indivi
The overall incidence of PPCs within 30 days postoperatively was 27.89% (70/251). Univariate analysis revealed significant intergroup differences in age, obesity, Trendelenburg positioning (25°-30° head-down tilt), and neutrophil-to-lymphocyte ratio (NLR) (all P < 0.05). Multivariate logistic regression confirmed that these four factors were independent risk factors for PPCs. Receiver operating characteristic curve analysis showed that the areas under the curve for age, obesity, Trendelenburg positioning, and NLR alone were 0.712, 0.715, 0.615, and 0.800, respectively. The combined prediction model incorporating all four indicators achieved an areas under the curve of 0.881.
Advanced age, obesity, failure to adopt the 25°-30° Trendelenburg head-down tilt during surgery, and elevated preoperative NLR were independent risk factors for PPCs following LRCRC. A combined prediction model based on these factors exhibits strong predictive performance for PPCs.
Core Tip: This study identified advanced age, obesity, absence of a 25°-30° Trendelenburg tilt during surgery, and an elevated preoperative neutrophil-to-lymphocyte ratio as independent risk factors for postoperative pulmonary complications after laparoscopic colorectal cancer resection. A combined prediction model based on these indicators demonstrated strong discriminative performance and showed potential for the early identification of high-risk patients.