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Postoperative gastrointestinal complications after lung volume reduction operations
I B Cetindag1, T M Boley, M J Magee
1Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, Springfield 62794-9638, USA.
The Annals of Thoracic Surgery
|October 6, 1999
Summary
Severe gastrointestinal (GI) complications occur in 9.4% of patients after lung volume reduction surgery for emphysema. Identifying risk factors like diabetes and steroid use can help prevent these serious complications and reduce mortality.
Area of Science:
- Pulmonary Medicine
- Gastroenterology
- Surgical Outcomes
Background:
- Lung volume reduction surgery (LVRS) improves quality of life for end-stage emphysema patients.
- Postoperative gastrointestinal (GI) complications are a concern following LVRS.
Purpose of the Study:
- To determine the frequency of GI complications after LVRS.
- To identify risk factors associated with severe GI complications in LVRS patients.
Main Methods:
- Retrospective review of 287 patients undergoing LVRS.
- Analysis of broad and severe postoperative GI complications.
- Identification of risk factors using logistic regression.
Main Results:
- Overall GI complication rate was 23% (137/67 patients).
- Severe GI complications occurred in 9.4% (27/287 patients), requiring abdominal operations in 7 patients.
- Risk factors for severe complications included diabetes (OR 7.02), steroid use (OR 2.81), and lower preoperative hematocrit.
- Mortality was significantly higher in patients with severe GI complications (22% vs 2%, p=0.0001).
Conclusions:
- Severe GI complications are not uncommon after LVRS and significantly increase perioperative mortality.
- Early recognition and management of identified risk factors are crucial for improving patient outcomes.