Abstract
Postoperative pulmonary complications in 367 thordcotomy cases of various chest diseases were analysed by preoperative lung function tests, serial chest X-ray films and, pre- and postoperative bacteriologic sputum findings.
Onset of postoperative pulmonary complications was determined by postoperative serial chest X-ray films showing newly developed atelectasis, pneumonia, pneumothorax, pleural effusion and wet lung more. The latter three findings were also observed in the contralateral lung field.
The following results were obtained;
1) The incidence of postoperative pulmonary complications was increased in patients with preexisting chronic inflammatory pulmonary lesions.
2) Postoperative pulmonary complications occured with greater frequency and magnitude in patients with poorer preoperative lung function as well as in older patients.
3) The incidence of postoperative pneumonia was higher in patients with bronchogenic carcinoma than in cases of benign lung diseases. Potentially serious cases of postoperative pneumonia were found in patients with gram-negative microorganism infection.
4) Patients having predisposing factors to postoperative pulmonary complications should undergo prophylactic treatment for the improvement of lung function before and during operation. These include preoperative chemotherapy, preoperative administration of γ-globulin, face-down position and use of a bronchial clamp during surgery.
