Preoperative Transthoracic Echocardiography in Laparoscopic Colorectal Surgery: Impact on Postoperative Cardiac Outcomes

Objective: This study aimed to assess the clinical utility of preoperative transthoracic echocardiography (TTE) in predicting postoperative major adverse cardiac events (MACEs) in patients undergoing laparoscopic colorectal surgery. Methods: A retrospective cohort study was conducted involving 1049 patients who underwent laparoscopic colorectal surgery between January 1st, 2018, and December 31st, 2018. Among these, 967 patients completed preoperative TTE, while 82 did not. Data collection encompassed basic patient information, medical history, ASA classification, and surgical details. The primary outcome was the occurrence of postoperative MACEs, which were defined based on myocardial enzyme levels, ECG results, and clinical events. Results: A total of 44 MACEs were identified, with congestive heart failure and new arrhythmias being the most prevalent. Univariate and multivariate regression analyses revealed that interventricular septal thickening (IVST) and left ventricular hypertrophy (LVH) were independent risk factors for MACEs, whereas the overall presence of TTE abnormalities was not significantly associated with postoperative MACEs. The study also highlighted that postoperative MACEs were significantly associated with increased hospitalization days and costs. Conclusion: Preoperative TTE abnormalities, specifically IVST and LVH, were found to be independent risk factors for postoperative MACEs. However, the routine use of TTE as a predictive tool for MACEs in this patient population may not be warranted based on the overall findings.