The Value Of Preoperative Lung Spironmetry Test For Evaluating The Postoperative Complication Of Gastric Cancer

Objectives Patients with gastric cancer were mostly older age，body functiondeclining，and most of them had preoperative diseases.Moreover,the range of gastriccancer surgery was larger，and the risk of the operation was higher. Thus, theincidence of postoperative complication was relatively higher. Preoperative lungspirometry was widely used to predict the occurrence of postoperative respiratorycomplications in the field of thoracic surgery; while in gastric cancer operation, it wasnot used frequently to evaluate postoperative complication. The aim of the presentstudy was to evaluate the value of preoperative lung function test for postoperativemorbidity among gastric cancer patients.Methods A total of200gastric cancer patients were enrolled between January2009and December2013in Zhongshan Hospital of Xiamen. Subjects were divided into thenormal pulmonary function group (n=158) and abnormal group (n=42), according tothe preoperative lung spirometry test. Meanwhile,the preoperative and postoperativeconditions of two group patients were analyzed, including age,smoking index,bodymass index, preoperative complications,pulmonary function testing, TNMstage,operative approach,operating time,and postoperative complications,time ofpostoperative hospital stay. The predictive value of lung spirometry for postoperativemorbidity was evaluated using the univariate and multivariate analysis.A P-value thatwas less than0.05was considered statistically significant.Results The pulmonary complication was more common among the postoperativecomplication of gastirc cancer. Patients with an abnormal pulmonary function had asignificantly greater incidence of postoperative complication when compared tonormal patients,in terms of the overall postoperative morbidity (45.2%vs24%,p=0.007), pulmonary complication(31%vs14.6%, p=0.014),lung infection (23.8%VS7%, p=0.004), pulmonary atelectasis（7.1%VS1.3%，p=0.031）.Meanwhile,theabnormal pulmonary function group had longer postoperative hospitalization time(18.21±6.2vs15.92±5.76,p=0.025)than the normal group. The univariate analysisand multivariate analysis revealed that an abnormal lung function (OR:8.124， 95%CI:1.76~37.36) was an independent predictive factor of postoperativecomplication after gastric cancer.Conclusion The preoperative lung spirometry test was found to be effectively for thescreening of an abnormal lung function and for estimating postoperative complica-tions after gastric cancer surgery. For patients undering gastric cancer operation, itshould be routine to take the lung spironmetry test before surgery. If we perform theproper perioperative intervention and the shorter operative time,it would undoubtedlyhelp to reduce the incidence of postoperative complication...