Complication Overview

Complications: Lobectomy, 2009-2013

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Lobectomy, surgical removal of a whole section (lobe) of lung, is the signature operation of a large thoracic surgery program. Lobectomy is almost always performed to cure lung cancer. Our complication profile and rates are superior to most large thoracic surgery programs. (Reference: Daniel J Boffa “Data from the Society of Thoracic Surgeons General Thoracic Surgery Database: The surgical management of primary lung tumors.” Cme.ctsnetjournals.org) This category includes lobectomy, sleeve lobectomy, bilobectomy, and segmentectomy.

Complications: Pneumonectomy, 2009-2013

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Removing an entire lung (pneumonectomy) has the potential of a huge impact on subsequent quality of life and historically carries a high risk of operative death and complications. There is no cardiac surgery that approaches the mortality rate for pneumonectomy, which is about triple that of mitral valve replacement (the highest risk cardiac surgery). For these reasons, Providence thoracic surgeons perform this surgery only as absolutely necessary to cure cancer or as a life-saving procedure. It is only performed in patients whose bodily processes are robust enough. Alternatives to pneumonectomy in appropriate patients include highly advanced procedures like sleeve resections, which is an equally effective cancer therapy with fewer complications.

Complications: Wedge Resections, 2009-2013

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Removing less than an entire lobe or lung, wedge resection, carries a smaller risk of complications or death. Wedge resection is used to diagnose other lung conditions (non-cancerous nodules or lung tissue inflammation) or occasionally to treat lung cancer in patients not robust enough to tolerate lobectomy.

Complications Definitions:

Pulmonary (lung)

  • Respiratory failure
  • Empyema (infection in chest cavity)
  • Pneumonia (infection in lung tissue)
  • Tracheostomy
  • Pulmonary embolism (blood clot to lung)
  • ARDS (acute respiratory distress syndrome) – fluid in lung tissue
  • Bronchopleural fistula – windpipe leak
  • Reintubation (unplanned) – breathing tube in windpipe
  • Prolonged ventilation (>48 hours post op)

Gastrointestinal (GI tract)

  • Prolonged ileus (intestinal paralysis) > 3 days
  • Mechanical bowel obstruction
  • Anastomotic leak (site of reconstruction) requiring surgery (re-op)

Wound

  • Deep infection – involving deep soft tissue layers such as fascia and muscle
  • Organ space infection – involving body cavity, such as empyema or mediastinitis (see STS for more info)

Other (inclusive)

  • New renal failure
  • Stroke
  • Thrombophlebitis (blood clot in limb vein)
  • Septicemia (infection in blood stream)
  • Reoperation
  • Infection requiring IV antibiotics
  • Unexpected admission to ICU

Additional Outcomes Data

Case Mix | Risk & Length of Stay | Mortality | Lung Resection | Complication Overview
Pulmonary Resection Complications | Other Thoracic Complications | Advanced Procedures