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

Eur J Cardiothorac Surg. 2012 Sep;42(3):420-9. doi: 10.1093/ejcts/ezs081. Epub 2012 Apr 5.

Abstract

Objectives: 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.

Methods: 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.

Results: 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%).

Conclusions: 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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Chi-Square Distribution
  • Confidence Intervals
  • Disease-Free Survival
  • Early Detection of Cancer / methods*
  • Female
  • Humans
  • Linear Models
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Netherlands
  • Pneumonectomy / methods*
  • Pneumonectomy / mortality*
  • Positron-Emission Tomography / methods
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery
  • Prognosis
  • Reoperation / methods
  • Reoperation / mortality
  • Risk Assessment
  • Survival Analysis
  • Thoracic Surgery, Video-Assisted / adverse effects
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracotomy / adverse effects
  • Thoracotomy / methods
  • Treatment Outcome

Associated data

  • ISRCTN/ISRCTN63545820