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. 2001 Jan;56(1):59–61. doi: 10.1136/thorax.56.1.59

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

H Uramoto 1, R Nakanishi 1, Y Fujino 1, H Imoto 1, M Takenoyama 1, T Yoshimatsu 1, T Oyama 1, T Osaki 1, K Yasumoto 1
PMCID: PMC1745907  PMID: 11120906

Abstract

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.



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Selected References

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