Early Outcome, Mortality and Major Morbidity after Lung Cancer Surgery for Primary Carcinoma

Abstract

Background: Radical surgical resection of lung cancer with or without adjuvant treatment is still a prerequisite for cure. Advances in operative and postoperative care led to a decline in complications and mortality rates during the last decades. In spite of different additional modes of treatment, survival is still poor. Methods: We analyzed 968 patients who underwent lung resection for bronchial carcinoma, with non-small cell lung cancer during a 12-year period (January 2004-December 2017). Postoperative events studied were divided into major and minor complications or death during the first 30 days after surgery. Results: Of 968 patient, 690 (70.5%) were male and 278 (28.7%) female. Mean age 65.5 ± 9.4 years (range: 15-87 years). Lobectomy was the most used surgical modality in 566 (58.5%) patients, meanwhile pneumonectomy was performed in 112 (11.6%) of patients. Minor complications during surgery occurred in 45 (11.7%) of patients. Continuous air leakage was the most complication after surgery in 25.3%, followed by lung atelectasis in 21.3% and cardiovascular complications in 17%. Of the life threatening complications respiratory failure was the most events in 20.0% of patients, followed by broncho-pleural fistula in 18.7% and pulmonary edema in 15% of patients. The 30-day mortality rate was 3.8% (37) patients, 1.2% after single lobectomy and 13.4 % after pneumonectomy. Conclusion: Our results show low mortality and morbidity after lung cancer surgery. However, patients with reduced lung capacity, older age and those undergoing pneumonectomy should be treated with great care.