Objective  To systematically evaluate the influencing factors of postoperative pulmonary infection in patients undergoing colorectal cancer surgery.

Methods  CNKI, WanFang Data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library databases were searched to systematically retrieve the relevant literature on the factors influencing the occurrence of postoperative pulmonary infection in patients with colorectal cancer from the inception of the databases to June 28, 2024. Stata 16.0 software was used for data analysis.

Results  A total of 25 articles and 16 043 colorectal cancer patients were included, containing 32 influencing factors.Results of Meta-analysis showed that age[OR=2.72, 95%CI(2.04-3.61), P<0.001], body mass index(BMI)[OR=3.761, 95%CI(2.10-6.75), P<0.001], male[OR=2.08, 95%CI(1.49-2.91), P<0.001], smoking history[OR=2.78, 95%CI(2.31-3.36), P<0.001], comorbid chronic respiratory disease [OR=4.18, 95%CI(2.70-6.47), P<0.001], comorbid diabetes mellitus[OR=2.59, 95%CI(1.66-4.05), P<0.001], comorbid hypoproteinemia[OR=4.15, 95%CI(1.95-8.83), P<0.001], preoperative albumin <35 g/L[OR=2.29, 95%CI(1.31-4.00), P=0.003], duration of surgery[OR=2.75, 95%CI(1.84-4.11), P<0.001], open surgery[OR=3.25, 95%CI(2.42-4.38), P<0.001], American Society of Anesthesiologists (ASA) score[OR=2.26, 95%CI(1.51-3.38), P<0.001], and intraoperative blood transfusion[OR=3.51, 95%CI(1.48-8.32), P=0.004] were the major influencing factors for postoperative complication of pulmonary infection in patients with colorectal cancer.

Conclusion  Age, BMI, male, smoking history, comorbid chronic respiratory disease, comorbid diabetes mellitus, comorbid hypoproteinemia, preoperative albumin <35 g/L, operation time, open surgery, ASA score, and intraoperative blood transfusion were all risk factors for postoperative pulmonary infection in patients undergoing colorectal cancer surgery. Effective prevention and treatment of chronic respiratory diseases, active guidence on patients to quit smoking, control blood glucose, and adjust nutritional diet, the improvement of preoperative screening and operating standard of the operator can help prevent and control postoperative complication of pulmonary infection in patients with colorectal cancer.

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