PULMONARY COMPLICATIONS IN PATIENTS UNDERGOING THORACOTOMY FOR LUNG-CARCINOMA

One hundred three consecutive patients undergoing 106 thoracotomies fo r primary lung carcinoma were reviewed to determine factors associated with the development of postoperative pulmonary complications. Pulmon ary complications occurred in 40 of 104 (39 percent) patients. Minor c omplications occurred in 17 of 104 (16 percent) patients and major in 23 of 104 (22 percent). There were six deaths in the entire series of 103 patients (6 percent), two of which were directly caused by a pulmo nary complication and one where it was a contributing factor. Extended surgical resections were associated with an increased risk of complic ations. Pulmonary complications occurred in 9 of 11 (82 percent) patie nts undergoing extended resections involving chest wan resection. The use of neoadjuvant chemotherapy also was associated with an increase i n the rate of major complications. Poor nutritional status as measured by a his tory of weight loss and preoperative serum albumin levels al so was associated with an increased risk of any pulmonary complication . Cardiac complications were significantly increased in the group of p atients having pulmonary complications. Pulmonary complications contin ue to present a major source of morbidity and mortality for patients u ndergoing thoracotomy for lung carcinoma. Determination of factors ass ociated with increased risk is important in order to identify patients who might be predisposed to the development of these complications.