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Eur J Cardiothorac Surg 2001;20:705-711
© 2001 Elsevier Science NL

Vocal cord dysfunction after left lung resection for cancer

^a Department of General and Thoracic Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
^b Department of Otolaryngology, Head and Neck Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
^c Department of Anesthesia, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
^d Department of Biostatistics, University of Auvergne, Clermont-Ferrand, France

Received 12 February 2001; received in revised form 10 May 2001; accepted 23 May 2001.

Corresponding author. Tel.: +33-4-7375-1567; fax: +33-4-7375-1566
e-mail: mfilaire{at}chu-clermontferrand.fr

Objectives: To evaluate the prevalence, the impact-related postoperative complications and the risk factors of vocal cord dysfunction (VCD) after left lung resection for cancer. Methods: From February 1996 to April 1999, a review of prospectively gathered data was performed on 99 consecutive patients who underwent a pneumonectomy (n=50) or a lobectomy (n=49) with a mediastinal lymph node dissection. A fiber optic laryngeal examination was performed preoperatively for all patients and within the first week postoperatively in patients with symptom(s) or sign(s) of VCD or respiratory complications. Results: Thirty-one patients (31%) had a postoperative VCD (group VCD) and 68 (68%) did not (group non-VCD). Mortality rate was 19% in group VCD and 9% in group non-VCD (P=0.13). Group VCD patients developed more pulmonary complications (P=0.014) and cardiac complications (P<0.001) compared to group non-VCD patients. A higher rate of reintubation (P=0.005), pneumonia (P=0.06), arrhythmia (P=0.002), cardiac failure (P<0.001) was noticeable in group VCD and may account for the higher rate of complications in this group. Using multivariate analysis, preoperative radiotherapy (P=0.001) and pneumonectomy (P=0.008) were predictive of postoperative VCD. Hospital stay was 22±16 days in group VCD and 13±9 days in group non-VCD (P<0.002). Conclusion: VCD is a frequent event that can lead to dramatic pulmonary complications. We would recommend to track it and to treat it as early as possible.

Key Words: Vocal cord dysfunction • Lung cancer • Postoperative complications

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