Vocal cord dysfunction after left lung resection for cancer

Objectives: To evaluate the prevalence, the impact-related postoperative complications and the risk factors of vocal cord dysfunction (VCD) after left lung resection for cancer. Methods: From February 1996 to April 1999, a review of prospectively gathered data was performed on 99 consecutive patients who underwent a pneumonectomy (n = 50) or a lobectomy (n = 49) with a mediastinal lymph node dissection. A fiber optic laryngeal examination was performed preoperatively for all patients and within the first week postoperatively in patients with symptom(s) or sign(s) of VCD or respiratory complications. Results: Thirty-one patients (31%) had a postoperative VCD (group VCD) and 68 (68%) did not (group non-VCD). Mortality rate was 19% in group VCD and 9% in group non-VCD (P = 0.13). Group VCD patients developed more pulmonary complications (P = 0.014) and cardiac complications (P < 0.001) compared to group non-VCD patients. A higher rate of reintubation (P = 0.005), pneumonia (P = 0.06), arrhythmia (P = 0.002). cardiac failure (P < 0.001) was noticeable in group VCD and may account for the higher rate of complications in this group. Using multivariate analysis, preoperative radiotherapy (P = 0.001) and pneumonectomy (P = 0.008) were predictive of postoperative VCD. Hospital stay was 22 +/- 16 days in group VCD and 13 +/- 9 days in group non-VCD (P < 0.002). Conclusion: VCD is a frequent event that can lead to dramatic Pulmonary complications. We would recommend to track it and to treat it as early as possible. (C) 2001 Elsevier Science B.V. All rights reserved.