Determinants of perioperative morbidity and mortality after pneumonectomy.
A total of 197 consecutive patients undergoing pneumonectomy at the M.D. Anderson Cancer Center from 1982 to 1987 were reviewed. Sixty-five variables were analyzed for the predictive value for perioperative risk. The operative mortality rate was 7% (14/197). Patients having a right pneumonectomy (n = 95) had a higher operative mortality rate (12%) than patients having a left pneumonectomy (1%, p less than 0.05). The extent of resection correlated with the operative mortality rate (chest wall resection or extrapleural pneumonectomy, n = 39, 15%; versus simple or intrapericardial pneumonectomy, n = 158, 5%; p less than 0.05). Patients whose predicted postoperative pulmonary function, by spirometry and xenon 133 regional pulmonary function studies, was a forced expiratory volume in 1 second greater than 1.65 L, forced expiratory volume in 1 second greater than 58% of the preoperative value, forced vital capacity greater than 2.5 L, or forced vital capacity greater than 60% of the preoperative value had a lower operative mortality rate (p less than 0.05). Atrial arrhythmia was the most common postoperative complication (23%). Xenon 133 regional pulmonary function studies are useful in predicting the risks of pneumonectomy.
Department of Thoracic Surgery, University of Texas, M.D. Anderson Cancer Center, Houston 77030.
R
R
Wahi
M J
MJ
McMurtrey
L F
LF
DeCaro
C F
CF
Mountain
M K
MK
Ali
T L
TL
Smith
J A
JA
Roth
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008176:Lung Volume Measurements; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects* / Q000401:mortality; D011300:Preoperative Care; D012123:Pulmonary Ventilation; D012307:Risk Factors; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes