Preoperative Pulmonary Function Tests Predict Aspiration Pneumonia After Gastric Endoscopic Submucosal Dissection

Area of Science:

• Gastroenterology
• Pulmonology
• Surgical Oncology

Background:

• Endoscopic submucosal dissection (ESD) offers high rates of en-bloc and R0 resections for gastric tumors.
• Aspiration pneumonia is a known complication of ESD, but its associated risk factors remain unclear.
• Understanding these factors is crucial for improving patient safety during ESD procedures.

Purpose of the Study:

• To investigate the relationship between preoperative pulmonary function test results and the incidence of aspiration pneumonia after gastric ESD.
• To identify specific preoperative factors that predict the risk of developing aspiration pneumonia.

Main Methods:

• Retrospective analysis of 978 patients undergoing gastric ESD between June 2006 and May 2014.
• Pulmonary function was assessed using spirometry and categorized into normal, restrictive, obstructive, and mixed patterns.
• Logistic regression analysis was used to identify independent risk factors for aspiration pneumonia.

Main Results:

• Aspiration pneumonia occurred in 3.7% of patients with abnormal pulmonary function versus 1.0% with normal function (p=0.010).
• Obstructive, restrictive, and mixed pulmonary dysfunction subgroups showed higher pneumonia rates (2.5%, 5.5%, 5.3% respectively).
• Pulmonary function, cerebrovascular disease, and procedure time were significant independent risk factors (ORs: 3.6, 5.1, 5.2).

Conclusions:

• Preoperative pulmonary function tests are valuable for assessing aspiration pneumonia risk after gastric ESD.
• Identifying patients with abnormal lung function can guide preventative strategies.
• These tests may aid in optimizing patient selection and management for ESD procedures.