Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3261-3268
Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3261
Relationship between intracranial pressure and neurocognitive function among older adults after radical resection of rectal cancer
Bo Song, Li-Ping Li, Xiao-Lin Wang, Yong Guo, Jun Li
Bo Song, Xiao-Lin Wang, Jun Li, Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, Mianyang 621000, Sichuan Province, China
Li-Ping Li, Department of Anesthesiology, Southwest Medical University, Luzhou 646000, Sichuan Province, China
Yong Guo, Department of Anesthesiology, The People’s Hospital of Yanting City, Mianyang 621000, Sichuan Province, China
Co-first authors: Bo Song and Li-Ping Li.
Author contributions: Song B and Li LP contributed equally to this manuscript, and they are the co-first authors of this manuscript; Song B was the guarantor and designed the study; Li LP, Wang XL, and Guo Y participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Guo Y and Li J revised the article critically for important intellectual content.
Supported by Sichuan Science and Technology Program, No. 2022NSFSC0611; and County-Hospital Research Project of Sichuan Hospital Association, No. 2023LC003.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Mianyang Central Hospital, Approval No. S-2021-007.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The experimental data used to support the findings of this study are available from the corresponding author upon request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Li, Doctor, Mianyang Key Laboratory of Anesthesia and Neuroregulation, Department of Anesthesiology, Mianyang Central Hospital, No. 12 Changfa Lane, Mianyang 621000, Sichuan Province, China. lj89199@163.com
Received: August 1, 2024
Revised: August 22, 2024
Accepted: September 3, 2024
Published online: October 27, 2024
Processing time: 56 Days and 22.2 Hours
Abstract
BACKGROUND

Older patients are prone to postoperative cognitive decline after laparoscopic rectal cancer surgery, which may be associated with increased intraoperative intracranial pressure (ICP). This study investigated the correlation between intraoperative ICP changes, as indicated by measurements of the optic nerve sheath diameter (ONSD) using ultrasonography, and subsequent cognitive function to provide better patient care.

AIM

To evaluate changes in ICP and associated postoperative neurocognition in older adults after laparoscopic radical resection for rectal cancer.

METHODS

We included 140 patients who visited the Mianyang Central Hospital for malignant rectal tumors, measured their ONSDs before surgery and 30 and 60 minutes after the Trendelenburg position during surgery, and evaluated the patients’ cognitive function 1 day before surgery and 1, 4, and 7 days after surgery. The Mini-Mental State Examination (MMSE) and confusion assessment method (CAM) scores of the patients with different ONSDs were compared at different times after surgery.

RESULTS

In patients with an ONSD greater than 5.00 mm (group A1), the MMSE scores at 1 day and 4 days after surgery were significantly lower than those of patients with an ONSD less than or equal to 4.00 mm (group A2) (P < 0.05). The CAM scores of group A1 were significantly higher than those of group A2 (P < 0.05). The MMSE scores of group A1 on days 1 and 4 after surgery were significantly lower than those 1 day before and 7 days after surgery (P < 0.05), while the CAM scores 1 day and 4 days after surgery were significantly higher than those 1 day before and 7 days after surgery.

CONCLUSION

Decline in cognitive function among older adults after the procedure may be related to intracranial hypertension during surgery.

Keywords: Ultrasound; Optic nerve sheath diameter; Intracranial pressure; Cognitive function; Radical resection; Rectal cancer

Core Tip: This study investigated the correlation between intraoperative intracranial pressure (ICP) changes measured by optic nerve sheath diameter via ultrasound and postoperative neurocognitive function in older patients undergoing laparoscopic radical resection for rectal cancer. These findings indicate that increased ICP during surgery is associated with significant postoperative declines in cognitive function, emphasizing the need to monitor and manage ICP to mitigate postoperative neurocognitive disorders.