title: Complications following lung surgery in the Dutch-Belgian randomized lung cancer screening trial.
abstract: OBJECTIVE
  To assess the complication rate in participants of the screen arm of the NELSON lung cancer screening trial who underwent surgical resection and to investigate, based on a literature review, whether the complication rate, length of hospital stay, re-thoracotomy and mortality rates after a surgical procedure were different from those of the non-screening series, taking co-morbidity into account.
  
  
  METHODS
  Between April 2004 and December 2008, 198 subjects underwent thoracic surgery. Co-morbid conditions were retrieved from the medical records. Postoperative complications were classified as minor and major.
  
  
  RESULTS
  In total, 182 thoracotomies, 5 thoracotomies after video-assisted thoracoscopic surgery (VATS) and 11 VATS procedures were performed. In these patients, 36% had chronic obstructive lung disease, 16% coronary artery disease, 14% diabetes mellitus and 11% peripheral vascular disease. Following thoracotomy, 47% (88/187) had ≥1 minor (7-57% in literature) and 10% (18/187) ≥1 major complication (2-26% in literature); following VATS, 38% (6/16) had ≥1 minor complication, but no major complications. Seventeen per cent (3/18) of major complications and 21% (20/96) of minor complications were seen in subjects operated for benign disease. The re-thoracotomy rate was 3% and there was no 30-day mortality after thoracotomy or VATS (0-8.3% in literature). The mortality rate of 0% after surgical procedures is low when compared with the non-screening series (0-8.3%); the rate of complications (53%) is within range when compared with the non-screening series (8.5-58%).
  
  
  CONCLUSIONS
  In conclusion, mortality rates after surgical procedures are lower in the NELSON lung cancer screening trial than those in the non-screening series. The rate of complications is within the same range as in the non-screening series.
  
  
  BACKGROUND
  ISR CTN 63545820.
authors.affiliation: Department of Pulmonology, Erasmus MC Rotterdam, Rotterdam, Netherlands. s.vantwesteinde@erasmusmc.nl
authors.forename: Susan C
authors.initials: SC
authors.lastname: Van't Westeinde
authors.forename: Nanda
authors.initials: N
authors.lastname: Horeweg
authors.forename: Paul
authors.initials: P
authors.lastname: De Leyn
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
authors.forename: Jan-Willem J
authors.initials: JW
authors.lastname: Lammers
authors.forename: Carla
authors.initials: C
authors.lastname: Weenink
authors.forename: Kristiaan
authors.initials: K
authors.lastname: Nackaerts
authors.forename: Rob J
authors.initials: RJ
authors.lastname: van Klaveren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D018572:Disease-Free Survival; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D016014:Linear Models; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009426:Netherlands; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality*; D049268:Positron-Emission Tomography / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D011379:Prognosis; D012086:Reoperation / Q000379:methods / Q000401:mortality; D018570:Risk Assessment; D016019:Survival Analysis; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome