Impact of previous gastrectomy on postoperative pneumonia after pulmonary resection in lung cancer patients

• Published in: Interactive cardiovascular and thoracic surgery Vol. 14; no. 6; pp. 750 - 753
• Main Authors: Kaneda, Hiroyuki, Nakano, Takahito, Taniguchi, Yohei, Saito, Tomohito, Konobu, Toshifumi, Saito, Yukihito
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.06.2012
• Subjects: Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung - surgery; Chi-Square Distribution; Female; Gastrectomy - adverse effects; Humans; Incidence; Institutional Reports; Japan; Logistic Models; Lung Neoplasms - surgery; Male; Multivariate Analysis; Odds Ratio; Pneumonectomy - adverse effects; Pneumonia, Aspiration - diagnostic imaging; Pneumonia, Aspiration - etiology; Pneumonia, Aspiration - prevention & control; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Risk Factors; Tomography, X-Ray Computed; Treatment Outcome; Complication; Pneumonia; Gastrectomy; Lung cancer
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivs083

Postoperative pneumonia is a serious complication following pulmonary resection. Aspiration of oesophageal reflux contents is known to cause pulmonary complications in patients with a history of gastrectomy. In this study, we compared the incidence of postoperative pneumonia in patients with or without previous gastrectomy. A retrospective review was conducted of clinical charts for patients who underwent radical pulmonary resection for non-small cell lung cancer from January 2006 to December 2010. Pneumonia was diagnosed with chest computed tomography findings in all cases. A total of 333 patients underwent pulmonary resections during the study period. Twenty-seven patients (8.1%) had a history of gastrectomy. Eight patients (2.2%) had postoperative pneumonia. All eight patients who developed postoperative pneumonia did not have pneumonia before pulmonary resection. Of the aforementioned 27 patients, five (18.5%) developed pneumonia postoperatively, whereas only three of 325 patients who did not have a history of gastrectomy (0.9%) had pneumonia (P < 0.001). In multivariate analysis, a history of gastrectomy had the highest impact on the odds ratio (8.81) for postoperative pneumonia. A significantly higher incidence of postoperative pneumonia was found in patients with a history of gastrectomy. Prophylactic treatment, such as premedication with ranitidine, should be considered in those patients.