title: Impact of previous gastrectomy on postoperative pneumonia after pulmonary resection in lung cancer patients.
abstract: 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.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. kanedah@hirakata.kmu.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kaneda
authors.forename: Takahito
authors.initials: T
authors.lastname: Nakano
authors.forename: Yohei
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: Tomohito
authors.initials: T
authors.lastname: Saito
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Konobu
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007564:Japan; D016015:Logistic Models; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011013:Pneumonectomy / Q000009:adverse effects*; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome