[Complications of pulmonary resection]

Surgical pulmonary resection remains the most effective treatment of non-small cell lung cancer which is its principal indication. Peri-operative mortality remains fairly high and is associated with post operative complications.

Complications can involve all the thoracic organs: lung, pleura, bronchi and chest wall and also the heart, blood vessels, nervous system and digestive tract. Individually, but often in combination, these complications can lead to post-operative respiratory failure which has a poor prognosis. Beside the pulmonary conditions that are familiar to the respiratory physician other factors add to the morbidity, notably: age, cardiovascular disease and neo-adjuvent therapies. Many of these complications can be explained by the operative procedure: extent of resection, lymph node dissection, adhesions, dissection of the mediastinum etc. These factors should be considered at an early stage in order to achieve prompt diagnosis and management. Broncho-pleural fistulae present major problems on account of both their prognosis and difficult management.

Many complications, especially cardiovascular, should be anticipated by the pre-operative investigations. Pneumonectomy remains a procedure with high morbidity and mortality. The risk factors should be taken into account when making a decision on surgical treatment.