title: Morbidity and mortality after pneumonectomy in smokers with NSCLC.
abstract: OBJECTIVE
  Perioperative morbidity and mortality in patients receiving pneumonectomy because of non-small cell lung cancer (NSCLC) remains quite high. The aim of this study is to identify risk factors to minimize perioperative mortality and morbidity.
  
  
  METHODS
  The results of 156 Patients who received pneumonectomy between 1995 and 2004 were reviewed retrospectively. All patients had stage I or II NSCLC. In 81 cases a right sided and in 75 a left sided pneumonectomy was performed. Cardiopulmonary function tests were sufficient for pneumonectomy.
  
  
  RESULTS
  Overall perioperative 30-day mortality was 7.1% (n=11), in hospital mortality 8.3% (n=13). The cause was sepsis in 6 cases, cardiac failure in 4 cases, and respiratory insufficiency in 3 cases. In univariable and multivariable regression analysis considering mortality, none of the prognostic factors reached significance. The odds ratio for postoperative death was 1.6 fold for smokers in comparison to non smokers. Complications after pneumonectomy were seen in 34.6%, with arrhythmia in 16.0%, sepsis in 1.9% and bronchopleural fistula (BPF) occurring in 6.4%. Smoking and intraoperative blood loss >500 ml were highly significant perioperative risk factors.
  
  
  CONCLUSIONS
  Smoking until operation and intraoperative blood loss were independent postoperative risk factors leading to complications after pneumonectomy for NSCLC. The risk for complications was 2.8-fold higher for smokers.
authors.affiliation: Department of Thoracic Surgery, Center for Pneumology and Thoracic Surgery, Schillerhöhe Hospital and Robert Bosch Hospital, Gerlingen, Deutschland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschbaum
authors.forename: Thomas
authors.initials: T
authors.lastname: Kyriss
authors.forename: Jürgen
authors.initials: J
authors.lastname: Dippon
authors.forename: Godehard
authors.initials: G
authors.lastname: Friedel