J Korean Surg Soc.  2013 Jan;84(1):18-26.

The value of preoperative lung spirometry test for predicting the operative risk in patients undergoing gastric cancer surgery

• Jeong O
• Ryu SY
• Park YK

Abstract

PURPOSE
We evaluated the predictive value of preoperative lung spirometry test for postoperative morbidity and the nature of complications related to an abnormal pulmonary function after gastric cancer surgery.
METHODS
Between February 2009 and March 2010, 538 gastric cancer patients who underwent laparoscopic (n = 247) and open gastrectomy (n = 291) were divided into the normal (forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] > or = 0.7, n = 441) and abnormal pulmonary function group (FEV1/FVC < 0.7, n = 97), according to the preoperative lung spirometry test. The predictive value of lung spirometry for postoperative morbidity was evaluated using the univariate and multivariate analysis.
RESULTS
After surgery, the abnormal pulmonary function group showed a significantly increased incidence of local (29.9% vs. 18.1%, P = 0.009) and systemic complications (8.2% vs. 2.0%, P = 0.005) than the normal group. Of local complications, anastomosis leakage and wound complication were found to be more common in the abnormal pulmonary function group. In the univariate and multivariate analysis, an abnormal pulmonary function was an independent predictor for postoperative local complication (odds ratio, 1.75; 95% confidence interval, 1.03 to 2.97) after adjusted by old age, total gastrectomy, open surgery, and tumor-node-metastasis stage. Meanwhile, an old age and a history of pulmonary disease were independent predictors for systemic complication.
CONCLUSION
Preoperative lung spirometry is a simple and useful means to predict postoperative morbidity after gastric cancer surgery. In view of its simplicity and low cost, we recommend adding preoperative lung spirometry test to assess the operative risk and aid in proper perioperative treatment planning.

Keyword

Stomach neoplasms; Morbidity; Spirometry; Chronic obstructive pulmonary disease; Respiratory function test

MeSH Terms

Gastrectomy
Humans
Incidence
Lung
Lung Diseases
Multivariate Analysis
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Spirometry
Stomach Neoplasms
Vital Capacity

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