Complications following lung surgery in the Dutch-Belgian randomized lung cancer screening trial

Susan C. van't Westeinde*, Nanda Horeweg, Paul De Leyn, Harry J. M. Groen, Jan-Willem J. Lammers, Carla Weenink, Kristiaan Nackaerts, Rob J. van Klaveren

*Corresponding author for this work

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Abstract

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.

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.

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%).

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.

Trial registration number: ISR CTN 63545820.

Original languageEnglish
Pages (from-to)420-429
Number of pages10
JournalEUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Volume42
Issue number3
DOIs
Publication statusPublished - Sep-2012

Keywords

  • Postoperative complications
  • Thoracotomy
  • Thoracic surgery
  • Video-assisted
  • Early detection of cancer
  • Lung neoplasms
  • MAJOR NONCARDIAC SURGERY
  • GENERAL-POPULATION
  • LOBECTOMY
  • RISK
  • VALIDATION
  • MANAGEMENT
  • RESECTION
  • SURVIVAL
  • NELSON
  • VOLUME

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