Prediction of postoperative pulmonary complications in oesophagogastric cancer surgery

Abstract

In a series of 102 patients with cancer of the oesophagus or gastric cardia in whom surgery had been performed, postoperative respiratory infection, respiratory failure and mortality secondary to respiratory complication occurred in 55.8, 34.3 and 21.6 per cent respectively. The incidence of complications correlated well with the pre-operative peak expiratory flow rate when it was <65 per cent of the predicted normal value. However, the predictive ability of peak expiratory flow rate was much less than the patient's age, pre-operative serum albumin level, preoperative P(a),(O2) and number of surgical wounds when all risk factors were considered. Significantly more complications occurred when the patient was >65 years old, P(a),(O2) was <10 kPa, serum albumin was <39 g/l and when the operation required three incisions. These findings may serve as guidelines for identification of high-risk patients in the future.