To investigate the lung protection and perioperative management in senior lung cancer patients with low pulmonary function.

The clinical data of 78 senior lung cancer patients aged ≥70 years undergoing surgical management in Huarun Wugang General Hospital between January 2009 and June 2014 were retrospectively analyzed, and the pulmonary function parameters before and after operation were retrieved. Patients were grouped according to the occurrence of postoperative cardiovascular and respiratory complications or based on the status of tracheal extubation. The prognostic factors of tracheal extubation after operation were explored by multivariate Logistic analysis.

All patients were cured during perioperation. There were significant differences in preoperative pulmonary function between complication group and non-complication group (χ²=25.807, P<0.01). There were also significant differences in preoperative pulmonary function and resection range between successful extubation group and delayed extubation group (χ²=10.953, P=0.027; χ²=7.033, P=0.031). The preoperative pulmonary function parameters of VC%, FEV_l% and MVV% in successful extubation group were significantly higher than those in delayed extubation group (P<0.01), and the postoperative predictive value of FEV_l%-ppo in successful extubation group was also significantly higher than that in delayed extubation group(P<0.01). Multivariate Logistic analysis demonstrated that low pulmonary function was closely related to the prognosis (P<0.05).

Preoperative improvement of pulmonary function, appropriate anesthesia management and individualized surgical approach during operation, and optimal postoperative mechanical ventilation are of vital importance to perioperative lung protection among senior lung cancer patients with low pulmonary function. Preoperative pulmonary function and resection range of the lung are associated with prognosis.