Complications after major pulmonary resections for lung cancer: A prospective study

Aim-Background The aim of this study was to evaluate the complications after major pulmonary resections for lung cancer and identify the risk factors associated with the occurrence of complications. We studied risk factors related to both clinical and laboratory characteristics of patients and those related to tumour stage, histology and type of surgery. Methods Between January 2011 and June 2012, 89 patients (mean age 64.4, ranging from 37 to 82 years) underwent major pulmonary resection at our institution for treatment of lung cancer. A univariate analysis was conducted to determine whether there were statistically significant group differences in the variables. Logistic regression analysis was performed to assess the impact of variables on the emergence of complications after the operation, including categorical and continuous variables. Results Complications occurred in 64% of patients, 79% of whom displayed complications that were not potentially life-threatening, 12.4% experienced a life-threatening complication, and 4.5% died. Intraoperative and postoperative bleeding, myocardial infarction, pulmonary embolism, bronchopleural fistula, adult respiratory distress syndrome, postoperative pneumonia and need for reoperation were among the complications that were considered as being potentially dangerous. Conclusions The preoperative haemoglobin levels and the need for transfusion are strongly associated with the occurrence of complications. Complications occurred in 75% of patients with chronic obstructive pulmonary disease, albeit these complications were not life-threatening. Diabetes mellitus is associated with critical complications. Prolonged hospitalization was observed primarily for persistent air leak, atelectasis, fever, and particularly after a right-sided procedure.