Surgery Today

, Volume 41, Issue 1, pp 60–66 | Cite as

The results of surgery under general anesthesia in patients with lung cancer

  • Ryuichi Suemitsu
  • Sadanori Takeo
  • Motoharu Hamatake
  • Akiko Morokuma
  • Yasuhiko Suemori
  • Hiroyuki Tanaka
Original Article



There are few reports of surgical complications for underweight patients. This study evaluated the complications associated with lung cancer surgery and anesthesia in underweight patients in a comparison with obese ones.


A single-center retrospective evaluation of perioperative complications was conducted in 756 patients who underwent thoracic surgery under general anesthesia between 1996 and 2006. The body mass index showed that 39 were extremely underweight (<17.2 kg/m2), 45 were underweight (17.2–18.4 kg/m2), 513 were normal (18.5–24.9 kg/m2), and 159 were obese (>24.9 kg/m2).


Extremely underweight patients had the most preoperative thoracic disease such as emphysema, whereas obese patients had the most preoperative cardiovascular disease such as hypertension. The postresection-predicted pulmonary function showed no difference among the four groups. Extremely underweight patients had an increased incidence of intraoperative hypotension and arrhythmia in comparison to underweight patients. On the other hand, obese patients had the majority of intraoperative thoracic complications such as hypoxia. Extremely underweight patients had more postoperative thoracic complications, especially pneumonia and pulmonary air leakage, than other patients.


Extremely underweight patients as well as obese patients had a high risk of perioperative complications, especially postoperative thoracic complications. Extremely underweight patients should therefore be carefully observed with regard to respiratory management.

Key words

Lung cancer General thoracic surgery General anesthesia Body mass index Complication 


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  1. 1.
    Shenkman Z, Shir Y, Brodsky JB. Perioperative management of the obese patient. Br J Anaesth 1993;70:349–359.CrossRefPubMedGoogle Scholar
  2. 2.
    Yoshino J, Akata T, Takahashi S. Intraoperative changes in arterial oxygenation during volume-controlled mechanical ventilation in modestly obese patients undergoing laparotomies with general anesthesia. Acta Anaesthesiol Scand 2003;47:742–750.CrossRefPubMedGoogle Scholar
  3. 3.
    Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med 1993;119:655–660.PubMedGoogle Scholar
  4. 4.
    Wigfield CH, Lindsey JD, Munoz A, Chopra PS, Edwards NM, Love RB. Is extremely obesity a risk factor for cardiac surgery? An analysis of patients with a BMI > or = 40. Eur J Cardiothorac Surg 2006;29:434–440.CrossRefPubMedGoogle Scholar
  5. 5.
    Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710–1717.CrossRefPubMedGoogle Scholar
  6. 6.
    Travis WD, Colby TV, Corrin B, Shimosato Y, Brambilla E. In collaboration with Sobin LH and pathologists from 14 countries. World Health Organization international histological classification of tumours. Histological typing of lung and pleural tumours. 3rd ed. Berlin: Springer; 1999.Google Scholar
  7. 7.
    Schutler J, Schwilden H, Stoekel H. Pharmacokinetics as applied to total intravenous anaesthesia. Practical implications. Anaesthesia 1983;38:53–56.Google Scholar
  8. 8.
    Organization of the Japanese Ministry of Health, Labor and Welfare (in Japanese). Available from:
  9. 9.
    Meyer PA, Mannino DM, Redd SC, Olson DR. Characteristics of adults dying with COPD. Chest 2002;122:2003–2008.CrossRefPubMedGoogle Scholar
  10. 10.
    Guerra S, Sherrill DL, Bobadilla A, Martinez FD, Barbee RA. The relation of body mass index to asthma, chronic bronchitis, and emphysema. Chest 2002;122:1256–1263.CrossRefPubMedGoogle Scholar
  11. 11.
    Inoue M, Sobue T, Tsugane S. JPHC Study Group. Impact of body mass index on the risk of total cancer incidence and mortality among middle-aged Japanese: data from a large-scale population-based cohort study — the JPHC study. Cancer Causes Control 2004;15:671–680.CrossRefPubMedGoogle Scholar
  12. 12.
    Sahebjami H, Sathianpitayakul E. Influence of body weight on the severity of dyspnea in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000;161:886–890.PubMedGoogle Scholar
  13. 13.
    Lindstrom D, Sadr Azodi O, Wladis A, Tonnesen H, Linder S, Nasell H, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg 2008;248:739–745.CrossRefPubMedGoogle Scholar
  14. 14.
    Barrera R, Shi W, Amar D, Thaler HT, Gabovich N, Bains MS, et al. Smoking and timing of cessation. Impact on pulmonary complications after thoracotomy. Chest 2005;127:1977–1983.CrossRefPubMedGoogle Scholar
  15. 15.
    Amar D, Roistacher N, Burt M, Reinsel RA, Ginsberg RJ, Wilson RS. Clinical and echocardiographic correlates of symptomatic tachydysrhythmias after noncardiac thoracic surgery. Chest 1995;108:349–354.CrossRefPubMedGoogle Scholar
  16. 16.
    Shenkman Z, Shir Y, Brodsky JB. Perioperative management of the obese patient. Br J Anaesth 1993;70:349–359.CrossRefPubMedGoogle Scholar
  17. 17.
    Suemitsu R, Sakoguchi T, Morikawa K, Yamaguchi M, Tanaka H, Takeo S. Effect of body mass index on perioperative complications in thoracic surgery. Asian Cardiovasc Thorac Ann 2008;16:463–467.PubMedGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  • Ryuichi Suemitsu
    • 1
    • 3
  • Sadanori Takeo
    • 1
  • Motoharu Hamatake
    • 1
  • Akiko Morokuma
    • 2
  • Yasuhiko Suemori
    • 2
  • Hiroyuki Tanaka
    • 2
  1. 1.Department of Thoracic SurgeryClinical Research Institute, National Hospital Organization, Kyushu Medical CenterFukuokaJapan
  2. 2.Department of AnesthesiologyClinical Research Institute, National Hospital Organization, Kyushu Medical CenterFukuokaJapan
  3. 3.Akimoto HospitalFukuokaJapan

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