Is routine preoperative spirometry necessary in elderly patients undergoing laparoscopy-assisted gastrectomy?

OBJECTIVES: To identify predictors of postoperative pulmonary complications (PPCs) in patients aged ≥ 60 years who underwent laparoscopy-assisted gastrectomy (LAG), and to examine the value of preoperative spirometry to predict PPCs. METHODS: Patients with preoperative spirometric results who underwent LAG were retrospectively studied. Spirometry included four parameters: forced expiratory volume in 1 s; functional vital capacity; mean forced expiratory flow during middle of functional vital capacity; peak expiratory flow rate. RESULTS: Of 213 patients, overall incidence of PPCs was 19.2%. Abnormal spirometry findings were not identified as an independent predictor of PPCs using multivariate logistic regression analysis. Age was found to be the only independent predictor of PPCs out of all variables evaluated. Separate assessment of individual spirometric parameters using receiver-operating curve analyses indicated poor diagnostic accuracy. CONCLUSIONS: Preoperative spirometry was not reliably predictive of PPCs, either as combined or individual parameters, in patients aged ≥ 60 years who underwent LAG. These results do not support routine use of spirometry to stratify risk of PPCs in this surgical population.