Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2024; 16(8): 2649-2661
Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2649
Innovative integration of lung ultrasound and wearable monitoring for predicting pulmonary complications in colorectal surgery: A prospective study
Chen Lin, Pei-Pei Wang, Zi-Yan Wang, Guo-Ru Lan, Kai-Wen Xu, Chun-Hua Yu, Bin Wu
Chen Lin, Pei-Pei Wang, Zi-Yan Wang, Guo-Ru Lan, Kai-Wen Xu, Chun-Hua Yu, Bin Wu, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Zi-Yan Wang, School of Medicine, Tsinghua University, Beijing 100084, China
Guo-Ru Lan, Chun-Hua Yu, Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Kai-Wen Xu, Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Co-first authors: Chen Lin and Pei-Pei Wang.
Author contributions: Wu B designed and revised the manuscript; Lin C, Wang PP, and Wang ZY collected clinical data, followed-up the patients, and wrote the manuscript; Lin C, Wang PP, and Wang ZY contributed to the analysis and statistics section; Wu B, Lin C, Lan GR, and Yu CH carried out the operation; Xu KW modified the article format. All authors have read and approved the final version to be published. Lin C and Wang PP contributed equally to this work as co-first authors.
Supported by National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-003; Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, No. 2021-1-I2M-015; and the Peking Union Medical College Hospital Undergraduate Educational Reform Project, No. 2020zlgc0116 and No. 2023kcsz004.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital.
Clinical trial registration statement: The clinical trial associated with this manuscript is registered with www.medicalresearch.org.cn under the registration number MR-11-24-024428. The registration details can be accessed at https://www.medicalresearch.org.cn/search/research/researchView?id=a78461dbd725-47ef-b986-58fd744a6e99.
Informed consent statement: The analysis used anonymous clinical data that were obtained after each patient agreed to treatment by providing written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
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: Bin Wu, MD, Chief Doctor, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Road, Wangfujing, Dongcheng District, Beijing 100730, China. wubin@pumch.cn
Received: May 10, 2024
Revised: June 26, 2024
Accepted: July 11, 2024
Published online: August 27, 2024
Processing time: 97 Days and 23.6 Hours
Abstract
BACKGROUND

Postoperative pulmonary complications (PPCs) are common in patients who undergo colorectal surgery. Studies have focused on how to accurately diagnose and reduce the incidence of PPCs. Lung ultrasound has been proven to be useful in preoperative monitoring and postoperative care after cardiopulmonary surgery. However, lung ultrasound has not been studied in abdominal surgeries and has not been used with wearable devices to evaluate the influence of postoperative ambulation on the incidence of PPCs.

AIM

To investigate the relationship between lung ultrasound scores, PPCs, and postoperative physical activity levels in patients who underwent colorectal surgery.

METHODS

In this prospective observational study conducted from November 1, 2019 to August 1, 2020, patients who underwent colorectal surgery underwent daily bedside ultrasonography from the day before surgery to postoperative day (POD) 5. Lung ultrasound scores and PPCs were recorded and analyzed to investigate their relationship. Pedometer bracelets measured the daily movement distance for 5 days post-surgery, and the correlation between postoperative activity levels and lung ultrasound scores was examined.

RESULTS

Thirteen cases of PPCs was observed in the cohort of 101 patients. The mean (standard deviation) peak lung ultrasound score was 5.32 (2.52). Patients with a lung ultrasound score of ≥ 6 constituted the high-risk group. High-risk lung ultrasound scores were associated with an increased incidence of PPCs after colorectal surgery (logistic regression coefficient, 1.715; odds ratio, 5.556). Postoperative movement distance was negatively associated with the lung ultrasound scores [Spearman’s rank correlation coefficient (r), -0.356, P < 0.05].

CONCLUSION

Lung ultrasound effectively evaluates pulmonary condition post-colorectal surgery. Early ambulation and respiratory exercises in the initial two PODs will reduce PPCs and optimize postoperative care in patients undergoing colorectal surgery.

Keywords: Colorectal cancer; Pulmonary complications; Lung ultrasound; Wearable devices; Respiratory exercises

Core Tip: This study investigates the role of lung ultrasound combined with wearable pedometer bracelets in assessing postoperative pulmonary complications (PPCs) in patients who underwent colorectal surgery. Higher lung ultrasound scores (≥ 6) are significantly associated with increased PPC incidence, whereas greater postoperative movement is linked to lower lung ultrasound scores. These findings emphasize the importance of early ambulation and respiratory exercises in reducing PPCs and improving postoperative care in patients undergoing colorectal surgery.