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Thorax 2001;56:59-61; doi:10.1136/thorax.56.1.59
Copyright © 2001 BMJ Publishing Group Ltd & British Thoracic Society.
Thorax 2001;56:59-61 ( January )

Prediction of pulmonary complications after a lobectomy in patients with non-small cell lung cancer

H Uramotoa, R Nakanishib, Y Fujinoc, H Imotoa, M Takenoyamaa, T Yoshimatsua, T Oyamaa, T Osakia, K Yasumotoa

a Department of Surgery II, School of Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka Yahatanishi-ku, Kitakyushu 807-8555, Japan, b Department of Thoracic Surgery, Shin-Kokura Hospital, Kitakyushu, Japan, c Clinical Epidemiology, School of Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan

Correspondence to: Dr H Uramoto hidetaka{at}med.uoeh-u.ac.jp

Received 1 June 2000; Returned to authors 26 July 2000; Revised version received 15 August 2000; Accepted for publication 18 September 2000

BACKGROUND---Although the preoperative prediction of pulmonary complications after lung major surgery has been reported in various papers, it still remains unclear.
METHODS---Eighty nine patients with stage I-IIIA non-small cell lung cancer (NSCLC) who underwent a complete resection at our institute from 1994-8 were evaluated for the feasibility of making a preoperative prediction of pulmonary complications. All had either a predicted postoperative forced vital capacity (FVC) of >800 ml/m2 or forced expiratory volume in one second (FEV1) of >600 ml/m2.
RESULTS---Postoperative complications occurred in 37 patients (41.2%) but no patients died during the 30 day period after the operation. Pulmonary complications occurred in 20 patients (22.5%). Univariate analysis indicated that the factors significantly related to pulmonary complications were FVC <80%, serum lactate dehydrogenase (LDH) level >= 230 U/l, and arterial oxygen tension (PaO2) <10.6 kPa (80 mm Hg). In a multivariate analysis the three independent predictors of pulmonary complications were serum LDH >= 230 U/l (odds ratio (OR) 10.5, 95% CI 1.4 to 77.3), residual volume (RV)/total lung capacity (TLC) >= 30% (OR 6.0, 95% CI 1.1 to 33.7), and PaO2 <10.6 kPa (OR 5.6, 95% CI 1.4 to 22.2).
CONCLUSIONS---The above findings indicate that three factors (serum LDH levels of >= 230 U/l, RV/TLC >= 30%, and PaO2 <10.6 kPa) may be associated with pulmonary complications in patients undergoing a lobectomy for NSCLC, even though the patient group was relatively small for statistical analysis of such a diverse subject as pulmonary complications.


Keywords: non-small cell lung cancer; pulmonary complications; morbidity

© 2001 by Thorax
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