Current operative morbidity associated with elective surgical resection for lung cancer

To determine the current operative morbidity for elective surgery of lung cancer, the authors reviewed the charts of 1076 consecutive patients who underwent pulmonary resection between 1978 and 1984 at two major Canadian teaching hospitals. Of these patients, 731 (68%) had a normal course. Minor complications occurred in 206 patients (19%); the majority were supraventricular arrhythmias (100 events) and atelectasis (41 events). Nonfatal major complications occurred in 105 patients (9.8%). The overall operative death rate was 3.2%. If supraventricular arrhythmias are excluded, nearly 80% of patients had a smooth postoperative course. In order to correlate the occurrence of complications with pre- and perioperative data, several possible risk factors were analysed. For major complications and death, the age, the forced expiratory volume, weight loss, coexisting disease, stage of cancer and extent of resection were significant risk factors (p less than 0.05). The data show that elective pulmonary surgery can be done safely and complications prevented. The necessary requirements are: proper selection of patients, a well-performed operation and prompt treatment of potential problems.