Complete Lobar Collapse Following Pulmonary Lobectomy

To define the most severe form of postlobectomy atelectasis and determine its incidence, predisposing factors, and clinical ramifications. Retrospective case control. The thoracic surgery unit at a 900-bed tertiary care hospital. Two hundred eighteen patients undergoing pulmonary lobectomy or bilobectomy over a 7-year time period. Severe postlobectomy atelectasis (SPLA) was defined as complete ipsilateral lobar or bilobar collapse with whiteout of the involved lobe(s) and mediastinal shift on the chest radiograph. Data were collected consisting of patient age, lobe(s) resected, type of postoperative pain control, length of hospital and ICU stay, preoperative pulmonary function, and single- vs double-lumen tube intubation during surgery. The incidence of SPLA was 7.8%, comprising 24.6% of all postoperative complications seen. There was no statistically significant difference in patient age, preoperative room air Po2, and preoperative FEX1/FVC ratio for the SPLA group vs the group without this complication. Patients with SPLA had significantly longer ICU stays (112.7 h vs 28.4 h; p