POSTOPERATIVE COMPLICATIONS AFTER PNEUMONECTOMY FOR TREATMENT OF LUNG-CANCER - MULTIVARIATE-ANALYSIS

The charts of 62 patients with primary lung cancer who underwent a pne umonectomy at our department from 1979 through 1992 were reviewed for the evaluation of postoperative morbidity and mortality. The 30-day mo rtality was 3/62 or 4.8%. Postoperative complication occurred in 37 of 62 patients (60%). The most common complication was a supraventricula r tachyarrythmia. A major complication, which was defined as one neces sitating re-thoracotomy or one which caused death, occurred in 19 pati ents (31%). We analyzed 43 perioperative variables for their predictiv e value of postoperative morbidity and mortality. Univariate analysis indicated that an elevated serum LDH, low predicted forced vital capac ity, low predicted forced expiratory volume in 1 sec (FEV(1)) were sig nificantly associated with the occurrence of a major complication. A m ultivariate logistic regression model indicated that a high LDH level, a low predicted FEV, and no extubation following surgery were associa ted independently with a postoperative major complication. Since only the complete removal of a tumor offers a chance for cure for the treat ment of non-small cell lung cancer, it is sometimes necessary to perfo rm a pneumonectomy for these high-risk patients. Patients identified a s being at high risk of a major complication should be candidates for intensive preoperative evaluation and perioperative care. (C) 1996 Wil ey-Liss, Inc.