Factors Affecting Early Morbidity After Pneumonectomy

Objective: To analyze factors affecting early morbidity after pneu-monictomy and evaluate the principles of perioperative managements. Methods: Between April 1983 and April 2003, 101 patients who underwent pneumonectomy were retrospectively reviewed, including primary lung cancer in 63 (62%) patients and benign pulmonary disease in 38(38%). Factors affecting early morbidity were analyzed by univaria-te and multivariate analysis. Results: Postoperative complications occurred in 44 patients (44%), including major complications in 13(13%) and death in 3(3%). Factors affecting total morbidity with univariate analysis included RV/TLC%, intrapericardial dissection, extended resection, diffuse pleural adhesion, operative time, volume of intraoperative blood transfusion, hospital stay, postoperative hospital stay (p<0.05), associated disease, FEV1%, total blood transfusion, total drainage volume (p < 0.01). Factors affecting morbidity with multivariate analysis included tuberculosis, associated cardiovascular disease, FEV1%, cancer, the volu- me of intraoperative crystalloid infusion (total complica- tion), tuberculo- sis, the volume of intraoperative crystalloid infusion (major complica- tion), FEV1% (respiratory complication), RV/TLC%, intrapericardial dissection, the volume of intraoperative saline infusion (cardiovascular complication), the volume of intraoperative crystalloid infusion, associated cardiovascular disease (surgical related complica tion). Conclusion: Multiple factors affected early morbidity after pneumonectomy. Appropriate selection and meticulous perioperative care are paramount to minimize risks in those patients who require pneumonic-tomy.