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Clinical Investigations: Lung CancerPulmonary Complications in Patients Undergoing Thoracotomy for Lung Carcinoma
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MATERIALS AND METHODS
One hundred three patients underwent 106 thoracotomies for primary lung cancer between February 1990 and September 1991 at Roswell Park Cancer Institute. (Three patients had staged thoracotomies for synchronous bilateral primaries.) Charts of these patients were retrospectively reviewed.
All patients had histologically proven lung carcinoma except one. This patient had a clinically diagnosed Pancoast tumor and received preoperative radiation. No carcinoma was found in the resected specimen,
RESULTS
One hundred six thoracotomies were performed, including 29 pneumonectomies, 57 lobectomies, 8 segmentectomies, 4 wedge resections, and 8 biopsies. Extended resections were performed in 25 patients. Included were 11 chest wall resections performed in combination with pulmonary resections (2 with pneumonectomy, 2 with lobectomy, and 1 with wedge resection) and 14 other extended resections. Three patients had staged bilateral thoracotomies for synchronous primary tumors. Two of these underwent
DISCUSSION
Pulmonary complications are a major cause of morbidity and mortality following thoracotomy in patients with lung cancer, as evidenced by the 39 percent pulmonary complication rate in this series. The overall mortality rate of 6 percent compares with the rate of 3.7 percent reported by Ginsberg et al23 in a recent large cooperative series of 2,200 patients undergoing resections for lung carcinoma.
Previous series have reported between 50 and 70 percent of deaths to be directly related to a
ACKNOWLEDGMENT
We wish to thank Dr. Leslie Blumenson for his contribution to the statistical analysis.
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Supported in part by Research grant CA 16056 awarded by the National Cancer Institute.