Prediction of postoperative pulmonary complications in lung cancer surgery: Is proportion of emphysema important?

Abstract

OBJECTIVE: Preoperative evaluation in thoracic surgery is highly important to determinesurgical suitability, estimate postoperative pulmonary complications, and for patient follow‑up.However, there is neither a definite explanation about the possible complications nor a goldstandard method.MATERIALS AND METHODS: In this study, 297 patients undergoing anatomic lung resection forprimary lung carcinoma were retrospectively evaluated. To form a homogeneous group, all factorsthat increase the rate of pulmonary complication were excluded except emphysema. Patients whodid not meet these criteria were removed from the study. The study continued with 104 other patients.This patient subgroup was divided into groups according to Goddard Classification– Score (GdCS).The correlation between GdCS and other variables was statistically investigated.RESULTS: According to the GdCS of 104 patients, the patient distribution was as follows:10 patients (9.6%) were G0, 28 patients (26.9%) were G1, 42 patients (40.4%) were G2,22 patients (21.2%) were G3, and 2 patients (1.9%) were G4. Thirty‑five (33.6%) of 104 patientshad a pulmonary complication during the postoperative follow‑up. The average drainage time waslonger for higher GdCS scores, and the rate of exposition to a pulmonary complication was higherin the patients with increased GdCS.CONCLUSION: In view of these findings, Goddard’s scoring for chronic obstructive pulmonarydisease‑emphysema patients was considered likely to be an indicative parameter in the preoperativeevaluation and postoperative follow‑up of thoracic surgery patients.