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Ann Thorac Surg 1989;48:33-37
© 1989 The Society of Thoracic Surgeons


Articles

Determinants of perioperative morbidity and mortality after pneumonectomy

Rakesh Wahi, MBBS, Marion J. McMurtrey, MD, Louis F. DeCaro, MD, Clifton F. Mountain, MD, Mohamed K. Ali, MD, Terry L. Smith, MS, Jack A. Roth, MD*

Departments of Thoracic Surgery, Medical Specialties (Cardiopulmonary Section), and Biomathematics, The University of Texas, M.D. Anderson Cancer Center, Houston, Texas USA

* Address reprint requests to Dr Roth, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 109, Houston, TX 77030.

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% ([equation]). Patients having a right pneumoneclomy (n = 95) had a higher operative mortality rate (12%) than patients having a left pneumonectomy (1%, p < 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 < 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 > 1.65 L, forced expiratory volume in 1 second > 58% of the preoperative value, forced vital capacity > 2.5 L, or forced vital capacity > 60% of the preoperative value had a lower operative mortality rate (p < 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.




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