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[Operative risk in thoracic surgery]
R Jancovici1, R Houel, F Natali
1Service de Chirurgie Thoracique, Hôpital du Val de Grâce, Paris.
Abstract:
Operative risk is encountered daily in thoracic surgery. Preoperatively, the risk can be evaluated by the pneumologist as well as the intensive care-surgery team. The parenchymal function and the patients respiratory capacity during the post-operative period should be evaluated. It is fundamental to evaluate heart function and vascular capacity. We discuss operative risk of dissection. The risk of bronchial fistulization is estimated at 5% (pneumonectomy) and 1% (lobectomy). Immediate complications include air leaks, rhythm disorders and post-operative bleeding. Thoracic drainage is a determining factor in thoracic surgery. The main problem remains post-operative respiratory failure especially since carcinological exeresis is usually carried out in patients with bronchopathies.