Abstract
Introduction
In order to assess short term outcomes of pulmonary resections in one year, a prospective observational study was made. To assess the predictive factors for postoperative complications.
Subject and methods
Twenty eight patients who underwent pulmonary resections were included in the study prospectively from January 2011 to December 2011 in a single unit in a tertiary care cancer hospital and short term outcomes were analysed.
Results
Twenty patients underwent pulmonary resection for malignant conditions and 8 for benign conditions. Surgeries performed were lobectomy in 9, bilobectomy in 5, pneumonectomy in 3, lobectomy with chest wall excision in 3 and wedge resection in 8 patients. Of 8 patients who underwent wedge resection; 7 were for benign conditions and one for metastatic gestational trophoblastic neoplasia. Six patients developed postoperative complications. Two had air leak, one patient had prolonged ICU stay (>1 week), one had pneumonia and 2 had surgical site infection. Pulmonary complications occurred in 2 patients, both had Diffusing Capacity of the Lung for Carbon Monoxide (DLCO) <80 %; one had pneumonia and the other was on mechanical ventilation for 48 hours and ICU for 9 days. Four of the patients who developed complication had Eastern Cooperative Oncology Group (ECOG) performance status of 3 and two of them who developed complication had ECOG performance status of two.
Conclusion
DLCO is an important predictor for postoperative complication apart from performance status, pulmonary function tests, smoking and diabetes mellitus.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs12055-013-0173-9/MediaObjects/12055_2013_173_Fig1_HTML.gif)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs12055-013-0173-9/MediaObjects/12055_2013_173_Fig2_HTML.gif)
Similar content being viewed by others
References
Romano PS, Mark DH. Patient and hospital characteristics related to in-hospital mortality after lung cancer resection. Chest. 1992;101:1332–7.
Whittle J, Steinberg EP, Anderson GF, et al. Use of Medicare claims data to evaluate outcome in elderly patients undergoing lung resection for lung cancer. Chest. 1991;100:729–34.
Datta D, Lahiri B. Preoperative evaluation of patients undergoing lung resection surgery. Chest. 2003;123:2096–103.
Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT, American College of Chest Physicians. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132:161S–77S.
Algar FJ, Alvarez A, Salvatierra A, Baamonde C, Aranda JL, López-Pujol FJ. Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg. 2003;23:201–8.
Stephan F, Boucheseiche S, Hollande J, et al. Pulmonary complications following lung resection. A comprehensive analysis of incidence and possible risk factors. Chest. 2000;118:1263–70.
Abolhoda A, Liu D, Brooks A, Burt M. Prolonged air leak following radical upper lobectomy: an analysis of incidence and possible risk factors. Chest. 1998;113:1507–10.
Patel RL, Townsend ER, Fountain SW. Elective pneumonectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg. 1992;54:84–8.
Wada H, Nakamura T, Nakamoto K, Maeda M, Watanabe Y. Thirty-day operative mortality for thoracotomy in lung cancer. J Thorac Cardiovasc Surg. 1998;115:70–3.
Deslauriers J, Ginsberg RJ, Piantadosi S, Fournier B. Prospective assessement of 30-day operative morbidity for surgical resections in lung cancer. Chest. 1994;106:329S–30S.
Harpole DH, Liptay MJ, DeCamp Jr MM, Mentzer SJ, Swanson SJ, Sugarbaker DJ. Prospective analysis of pneumonectomy: risk factors for major morbidity and cardiac dysrhythmias. Ann Thorac Surg. 1996;61:977–82.
Busch E, Verazin G, Antkowiak JG, Driscoll D, Takita H. Pulmonary complications in patients undergoing thoracotomy for lung carcinoma. Chest. 1994;105:760–6.
Dales RE, Dionne G, Leech JA, Lunau M, Schweitzer I. Preoperative prediction of pulmonary complications following thoracic surgery. Chest. 1993;104:155–9.
Mitsudomi T, Mizoue T, Yoshimatsu T, et al. Postoperative complications after pneumonectomy for treatment of lung cancer: multivariate analysis. J Surg Oncol. 1996;61:218–22.
Kearney DJ, Lee TH, Reilly JJ, DeCamp MM, Sugarbaker DJ. Assessement of operative risk in patients undergoing lung resection: importance of predicted pulmonary function. Chest. 1994;105:753–9.
Ferguson MK, Little L, Rizzo L, et al. Diffusing capacity predicts morbidity and mortality after pulmonary resection. J Thorac Cardiovasc Surg. 1988;96:894–900.
Yano T, Yokoyama H, Fukuyama Y, Takai E, Mizutani K, Ichinose Y. The current status of postoperative complications and risk factors after a pulmonary resection for primary lung cancer, a multivariate analysis. Eur J Cardiothorac Surg. 1997;11:445–9.
Birim O, Zuydendorp M, Maat APWM, et al. Lung resection for non-small-cell lung cancer in patients older than 70. Ann Thorac Surg. 2003;76:1796–801.
Osaki T, Shirakusa T, Kodate M, Nakanishi R, Mitsudomi T, Ueda H. Surgical treatment of lung cancer in the octogenarian. Ann Thorac Surg. 1994;57:188–93.
Brunelli A, Refai MA, Salati M, Sabbatini A, Morgan-Hughes NJ, Rocco G. Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection. Eur J Cardiothorac Surg. 2006;29:567–70.
Ferguson MK, Vigneswaran WT. Diffusing capacity predicts postoperative morbidity after major lung resection in patients without obstructive pulmonary disease. Ann Thorac Surg. 2008;85:1158–65.
Ferguson MK, Gaissert HA, Grab JD, Sheng S. Pulmonary complications after lung resection in the absence of chronic obstructive pulmonary disease: the predictive role of diffusing capacity. J Thorac Cardiovasc Surg. 2009;138:1297–302.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Swamyvelu, K., Challa, V.R., Rangappa, P. et al. Pulmonary resections in a tertiary care center—a prospective observational study of outcome. Indian J Thorac Cardiovasc Surg 28, 229–233 (2012). https://doi.org/10.1007/s12055-013-0173-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12055-013-0173-9