Complications in Patients Undergoing Pulmonary Oncological Surgery

Česká verzia

Authors: L. Mitáš; T. Horváth; M. Sobotka; B. Garajová; I. Hanke; Z. Kala; I. Penka ; J. Ivičič; J. Vomela
Authors place of work: Chirurgická klinika FN Brno a LF MU, přednosta: prof. MUDr. Zdeněk Kala, CSc.
Published in the journal: Rozhl. Chir., 2010, roč. 89, č. 2, s. 113-117.
Category: Monothematic special - Original

Summary

Aim:
A survey evaluating incidence and risk factors of complications in persons underwent complete open lung resection because of primary or secondary lung malignancy.

Material and methods:
Retrospective study of 189 open surgery procedures in 128 males and 61 females, mean age males 61 years (range 21–78), females 64 years (range 33–80) during a five-years period (2003–2007). Data processing and analysis were performed with the statistical software system Statistica and compared by parametres odds ratio a χ2 test.

Results:
Complications were divided into five groups. First group was defined as complications in perioperative period and was composed of three events 1.5%: endotracheal tube dysfunction (i.e. 0.5%), heavy cardiac arrhytmia 0.5% and serious haemorrhage, that occurred immediately after operation 0.5%. Second group includes complications within period of 7 days after surgery: prolonged air leak (PAL > 7 days) 7.4%, bronchopneumonia 6.9%, cardiac arrhythmia 6.9%, postoperative delirium 4.2%, atelectasis 2.6%, wound infection 1.1%, bleeding 1.1% and chylothorax 0.5%. Third group contains events between 8th and 30th postoperative days: thoracic empyema 2.1%, dysphonia 2.1%, painfull shoulder 1.1 %, alimentary tract infection 0.5% and bronchial closure insufficiency 0.5 %. Fourth group contains patients with severe complications, that led to death during 30 days after operation: ischemic stroke 0.5% and pulmonary embolism 0.5%. Patients without any complication formed the fifth group of 60.5%.

Conclusion:
Main risk factors for complications in postoperative period after lung resection due to primary or secondary lung malignancy in our group of patients are COPD, corticotherapy, time of operation over 3 hours, BMI over 25, left side tumor localization and bronchoplastic procedure. For cardiac arrhytmia seems to be risk factor pneumonectomy and previous neoadjuvant radiochemotherapy.

Key words:
surgery complications – lung cancer surgery – lung cancer

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