Postoperative respiratory complications and peak airway pressure during laparoscopic colectomy in patients with colorectal cancer.

To determine whether the incidence of postoperative pulmonary complications increases in patients with high peak airway pressure (≥30 cm H2O) during laparoscopic colectomy, we investigated consecutive patients with colorectal cancer who had undergone laparoscopic colectomy. Of the 115 enrolled patients, 34 patients (30%) had peak airway pressure ≥30 cm H2O (an overload group). Compared with a nonoverload group (peak airway pressure <30 cm H2O), the overload group had a 5-fold greater incidence of postoperative respiratory complications and operations of longer duration, longer postanesthesia care unit stays, greater alveolar-arterial O2 differences, greater alveolar dead space-to-tidal volume ratios, and lower PaO2 measurements. Body mass index and preoperative alveolar-arterial O2 difference significantly affect higher peak airway pressure occurring during laparoscopic colectomy. Patients who had peak airway pressures ≥30 cm H2O during laparoscopic colectomy for colorectal cancer had higher incidence of postoperative respiratory complications than those whose peak airway pressures remained <30 cm H2O.