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 ðn ¼ 50Þ or a lobectomy ðn ¼ 49Þ 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 ðP ¼ 0:13Þ. Group VCD patients developed more pulmonary complications ðP ¼ 0:014Þ and cardiac complications ðP , 0:001Þ compared to group non-VCD patients. A higher rate of reintubation ðP ¼ 0:005Þ, pneumonia ðP ¼ 0:06Þ, arrhythmia ðP ¼ 0:002Þ, cardiac failure ðP , 0:001Þ was noticeable in group VCD and may account for the higher rate of complications in this group. Using multivariate analysis, preoperative radiotherapy ðP ¼ 0:001Þ and pneumonectomy ðP ¼ 0:008Þ were predictive of postoperative VCD. Hospital stay was 22 ^ 16 days in group VCD and 13 ^ 9 days in group non-VCD ðP , 0:002Þ. 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. q 2001 Elsevier Science B.V. All rights reserved.