Vocal cord dysfunction after left lung resection for cancer.
OBJECTIVE
To evaluate the prevalence, the impact-related postoperative complications and the risk factors of vocal cord dysfunction (VCD) after left lung resection for cancer.


METHODS
From February 1996 to April 1999, a review of prospectively gathered data was performed on 99 consecutive patients who underwent a pneumonectomy (n=50) or a lobectomy (n=49) with a mediastinal lymph node dissection. A fiber optic laryngeal examination was performed preoperatively for all patients and within the first week postoperatively in patients with symptom(s) or sign(s) of VCD or respiratory complications.


RESULTS
Thirty-one patients (31%) had a postoperative VCD (group VCD) and 68 (68%) did not (group non-VCD). Mortality rate was 19% in group VCD and 9% in group non-VCD (P=0.13). Group VCD patients developed more pulmonary complications (P=0.014) and cardiac complications (P<0.001) compared to group non-VCD patients. A higher rate of reintubation (P=0.005), pneumonia (P=0.06), arrhythmia (P=0.002), cardiac failure (P<0.001) was noticeable in group VCD and may account for the higher rate of complications in this group. Using multivariate analysis, preoperative radiotherapy (P=0.001) and pneumonectomy (P=0.008) were predictive of postoperative VCD. Hospital stay was 22+/-16 days in group VCD and 13+/-9 days in group non-VCD (P<0.002).


CONCLUSIONS
VCD is a frequent event that can lead to dramatic pulmonary complications. We would recommend to track it and to treat it as early as possible.
Filaire
M
M
Department of General and Thoracic Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France. mfilaire@chu-clermontferrand.fr
Mom
T
T
Laurent
S
S
Harouna
Y
Y
Naamee
A
A
Vallet
L
L
Normand
B
B
Escande
G
G
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008176:Lung Volume Measurements; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D061226:Recurrent Laryngeal Nerve Injuries; D012307:Risk Factors; D061223:Vagus Nerve Injuries; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000401:mortality