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European Journal of Cardio-Thoracic Surgery, Vol 11, 445-449, Copyright © 1997 by European Association for Cardio-thoracic Surgery
T Yano, H Yokoyama, Y Fukuyama, E Takai, K Mizutani and Y Ichinose
OBJECTIVE: The purpose of the present study is to identify the current
postoperative complications after a pulmonary resection for primary lung
cancer and the associated risk factors. METHODS: From 1988 to 1992, 291
patients with primary lung cancer, excluding T4 diseases, consecutively
underwent a pulmonary resection at our institute. The observed
postoperative complications were divided into non-life- threatening ones
(simple arrhythmia, atelectasis, liver dysfunction, etc.) and
life-threatening ones (respiratory failure, pyothorax, pneumonia,
bronchopleural fistula, cardiac failure, cerebral infarction, myocardial
infarction, etc.). Using logistic regression procedures, both univariate
and multivariate analyses of the association between various perioperative
factors and the incidence of postoperative complications were performed.
RESULTS: Non-life- threatening complications occurred in 60 patients
(20.6%) while life- threatening ones occurred in 36 (12.4%), and resulted
in five in- hospital deaths (1.75%). Multivariate analyses showed that an
age of 70 or older, a combined resection, an abnormality on preoperative
ECG, and diffusing capacity of carbon monoxide (%DLco) below 70 were all
independently associated with an increased non-life-threatening morbidity.
On the other hand, an age of 70 or older, the need for a pneumonectomy, and
a %DLco below 70 were also independently predominant risk factors for
life-threatening morbidity. CONCLUSION: The risk factors for
life-threatening morbidity therefore did not completely correspond to those
for non-life-threatening morbidity. Since the mortality was quite low, even
risk factors for life-threatening morbidity were not solely considered to
be a contraindication for a major pulmonary resection.
ARTICLES
The current status of postoperative complications and risk factors after a pulmonary resection for primary lung cancer. A multivariate analysis
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
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