Clinical study of the hospital mortality and morbidity after thoracic surgery

Abstract

In the Department of Thoracic surgery at our hospital, over 13 year period from 1987 to 1999, 1, 005 patients underwent thoracic surgery for primary lung cancer (n=496) and other respiratory diseases (n=509). Of these, 106 patients (10.5%) received therapy for postoperative complications. The main complications were difficulty expectorating (33), prolonged airleakage (14), atrial fibrillation (13) and postoperative bleeding (11). Eight patients (0.8% of all patients and 1.6% of those with primary lung cancer) died of postoperative complications or lung cancer, five within 30 days and three after 30 days. The operative mortality, including all in-hospital deaths, was 0.8% for lobectomy (3/351) and 11.1% for pneumonectomy (4/36). The causes of deaths within 30 days were acute myocardial infarction, bronchopulmonary arterial fistula, ARDS, cerebral infarction, and suicide due to depression. The causes of hospital deaths after more than 30 days were empyema with bronchopleural fistula after pneumonectomy and disseminated intravascular coagulation due to lung cancer. In conclusion, greater care should be taken in selection of the pneumonectomy patients and in careful postoperative management.