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

摘要

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 independentpredictors of pulmonary complications were serum LDH ⩾230 U/l (oddsratio (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), andPaO2 <10.6 kPa (OR 5.6, 95% CI 1.4 to 22.2).
CONCLUSIONS—The abovefindings indicate that three factors (serum LDH levels of ⩾230 U/l,RV/TLC ⩾30%, and PaO2 <10.6 kPa) may beassociated with pulmonary complications in patients undergoing alobectomy for NSCLC, even though the patient group was relatively small for statistical analysis of such a diverse subject as pulmonary complications.