Analysis Of Risk Factors For Postoperative Pulmonary Complications In Gastric Cancer.(With 16425 Cases Of Case Analysis)

Objective: To identify the risk factors for postoperative pulmonary complications in patients after gastric cancer surgery,to provide theoretical basis for reducing the incidence rate of postoperative pulmonary complications.Methods: A retrospective study was conducted to collect clinical case data from 16425 patients who underwent gastric cancer surgery in our hospital from January 1965 to December 2015.On the basis of postoperative pulmonary complications,they were divided into non pulmonary complications group with 16182 cases included in the control group,and complications group in the observation group with 243 cases included.There were 24 clinical indexes in total.The involved clinical factors were divided into preoperative indexes,tumor factors and surgical factors.Preoperative indexes included gender,age,drinking history,smoking history,abdominal surgery,diabetes,hypertension,heart disease,hypoproteinemia,basic lung disease,preoperative chemotherapy and preoperative anemia.There were tumor infiltration depth,tumor size,tumor site,lymph node metastasis and TNM staging in Tumor factors.Surgical factors included surgical characteristics,surgical methods,radical degree,open and endoscopic,thoracotomy and open laparotomy,anastomotic approach,and combined organ.Statistical analysis was performed through the SPSS 21.0 software,Ρ<0.05 was considered to be statistically significant.Independent risk factors of screening using Logistic regression analysis,Ρ<0.05 was significant difference.Results: In this study,there were 243 patients with postoperative pulmonary complications in 16425,the rate was 1.48%.Through this study,we found that there were 32 cases of pulmonary infection,144 cases of pleural effusion,1 case of atelectasis,4 cases of pulmonary embolism,6 cases of liquid and gas chest,3 cases of pneumothorax,20 cases of respiratory failure,7 cases of acute respiratory distress syndrome(ARDS)and 26 cases of multiple pathological types in some patients.The single factor analysis results show that gastric cancer patients with postoperative pulmonary complications were concerned with age,basic lung disease,preoperative anemia,lymph node metastasis,surgical methods,thoracotomy and open laparotomy,anastomotic approach,combined organ,tumor site,tumor size,depth of invasion and TNM staging.Logistic regression analysis showed that age,lymph node metastasis,surgical methods,anastomotic approach,combined organ,tumor site,tumor size and TNM staging can significantly increase the incidence of postoperative pulmonary complications in patients with gastric cancer.Conclusions:1.In this study,there were 243 patients with postoperative pulmonary complications in 16425,the rate was 1.48%.Risk factors of postoperative pulmonary complications included age,lymph node metastasis,surgical methods,anastomotic approach,combined organ,tumor site,tumor size and TNM staging,which can significantly increase the incidence of pulmonary complications.2.As time went on,we concluded that the incidence of postoperative pulmonary complications in gastric cancer patients tended to gradually increase and then slowly decline.