Risk Factors Of Pulmonary Complications After Laparoscopic Gastric Cancer Radical Surgery In Elderly Patients

Background and purpose of the study:Gastric cancer is a common malignant tumor of the digestive system.Surgery is the main treatment method.With the development of laparoscopic technology and the extension of life expectancy,more and more elderly patients undergo laparoscopic radical gastric cancer surgery.This study aimed to investigate the risk factors for pulmonary complications in elderly patients undergoing laparoscopic radical gastrectomy.It also provides a reference for interventions in clinical work.Research method:This study retrospectively analyzed the clinical data of patients undergoing laparoscopic radical gastrectomy for gastric cancer in the First Hospital of Jilin University from 2016 to 2018.According to the study’s entry and exclusion criteria,341 patients who met the criteria were selected.Patient’s gender,age,height,weight,BMI,preoperative serum albumin,preoperative hemoglobin,blood transfusion,formerly medical history(hypertension,diabetes,coronary heart disease),smoking history,pulmonary function(FEV1/FVC,MVV%,Lung reserve rate),combined basic lung diseases,surgical methods,operation time,whether to indwell gastric tube and other data were counted.The elderly patients were divided into two groups according to whether postoperative pulmonary complications occurred.The patients with pulmonary complications were the observation group.The patients without postoperative complications were the control group.The data was processed by SPSS 22.0 statistical software.Logistic regression multivariate analysis was used,and P<0.05 was considered statistically significant.Research result:There were 56 cases of pulmonary complications in all patients,accounting for 16.42%of the total.Univariate analysis:smoking history,preoperative hemoglobin,preoperative serum albumin,pulmonary disease,operation time,indwelling gastric tube,FEV1/FVC<0.7 and MVV%<0.6 were related to pulmonary complications after laparoscopic gastric cancer radical surgery in elderly patients(P<0.05).Multivariate analysis:smoking history,pulmonary disease,preoperative albumin are independent risk factors for postoperative pulmonary complications in elderly patients(P<0.05,OR values were5.774,2.793,4.236,respectively).Research conclusions:Elderly patients with a history of smoking,preoperative hemoglobin<110g,preoperative serum albumin=<35g/L,combined lung disease,operation time>3h,indwelling gastric tube,FEV1/FVC<0.7,MVV%<0.6 are more likely to have pulmonary complications after surgery.Among them,smoking history,pulmonary disease,preoperative serum albumin=<35g/L were independent risk factors.