Main problems about patients with pulmonary dysfunction during laparoscopic surgery        DAI Meng-hua. Department of General Surgery, Peking Union Medical College Hospital ,Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730,China
Abstract    Because expertise and equipment have improved, laparoscopy has become one of the most common surgical procedures performed on an outpatient basis and to sicker patients, rendering managements of patients for laparoscopy technically difficult and challenging. Some factors impact the outcomes of patients after laparoscopic procedure, including carbon dioxide pneumoperitoneum，abdominal pressure，extremes of patient positioning, morbidly obese and type of anesthesia, even leading to pathophysiological changes of patients. A thorough understanding of the pathophysiological changes is fundamental for optimal anesthetic care and perioperative management of patient with dysfunction of respiratory. It considers the pathophysiological changes of respiratory system during laparoscopy using carbon dioxide for intraabdominal insufflation, discusses various techniques to reduce postoperative pulmonary complications, such as preoperative assessment and treatment of pulmonary disease, intraoperative monitoring the changes of respiratory function, usefulness of fast track anesthesia and postoperative treatments of pain.