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Factors associated with perioperative complications after pneumonectomy for primary carcinoma of the lung

Maciej Dancewicz, Janusz Kowalewski^* and Janusz Pepliski

Department of Thoracic Surgery and Tumors, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Centrum Onkologii, Ul. I. Romanowskiej 2, 85-796 Bydgoszcz, Poland

*Corresponding author. Tel.: +4852 374 3573; fax: +4852 374 3301.

E-mail address: kowalewskij{at}rco.pl (J. Kowalewski).

According to the literature patient's age, nutrition and smoking status, cardiopulmonary comorbidity and surgeon's experience are the main factors associated with perioperative complications after pulmonary resection. The purpose of the study was to identify the correlation between pre- and intraoperative risk factors and complications after pneumonectomy for primary carcinoma of the lung. Between Sept. 11th 1999 and Dec. 20th 2003 121 standard pneumonectomies were performed in patients with non small-cell lung cancer. Sixteen risk factors noted in the patients before surgery were correlated with complications occurred after pneumonectomy. Overall mortality and morbidity rates were 3.3% and 30.6%, respectively. Twenty patients (16.5%) experienced cardiac rhythm disturbances, six (4.9%) – pleural haematomas, five (4.1%) – main bronchus stump fistulas, four (3.3%) – acute respiratory failure. Chronic obstructive pulmonary disease was correlated with broncho-pleural fistulas and acute respiratory failure after surgery. Chronic coronary disease was associated with postoperative cardiac arrhythmias, whereas postoperative bleeding was correlated with the overweight of the patients. Chronic obstructive pulmonary disease, chronic coronary disease and overweight are the risk factors associated with complications after pneumonectomy.

Key Words: Pneumonectomy; Mortality; Morbidity; Risk factors; Pulmonary complications