Cardiac arrhythmia after lung cancer surgery-analysis of 140 pneumonecttomy cases

Abstract

Among 808 surgically resected lung cancer cases at Shanghai Chest Hospital during 1991 to 1992, 140 of them (17.3%) underwent pneumonectomy. Of the 140 cases: 124 male, 16 female; aged 27–74 yrs, 35.7% elder (60 and over), preoperative abnormal EKG was found in 38 cases; operative mortality was 4.3%. The histopathological diagnosis were: squamous 43.6%, adeno. 36.4%, small cell 8.6%, mixed type 11.4%. The pTNM stages: stage I 2.9%, II 17.1%, IIIa 55.0%, IIIb 21.4%, IV 3.6%. Postoperatively, arrhythmia occuried in 76 cases, with an incidence of 54.3%. Of the 76 arrhythmias, atrial fibrillation was seen in 7 patients, atrial premature beats in 2, supraventricular tachycardia in 1, and sinus tachycardia in 66. The incidences of cadiac arrhythmia during the postoperative day (D0), first day (D1), D2, D3, and D4 were 48.7%, 35.5%, 7.9%, 4.0% and 2.6% respectively. Conclusion: the cardiac arrhythmia is the most common complication after pneumonectomy for lung cancer surgery. The major causes were incisional pain, hypovolemia due to blood loss and respirative insufficiency due to anomia. The perioperative prevention and treatment for arrhythmia were also discussed.