F-056OUTCOMES OF ANATOMIC LUNG RESECTIONS IN BRAZIL: RESULTS OF A NATIONAL DATABASE FROM THE BRAZILIAN SOCIETY OF THORACIC SURGERY

Abstract

Objectives: Analyze morbidity and mortality of anatomic lung resections in Brazil. Methods: The Brazilian Society of Thoracic Surgery (BSTS) has partnered with ESTS and since August 2015 uses a customized version of the ESTS platform as its national database (BSTS Database), and in December 2015, 1367 patients were already registered. In the current analysis, we included patients who underwent anatomic lung resections; wedge resections and unspecified cases were excluded. The main outcome was postoperative mortality (in-hospital) and the secondary outcome was complication rate and profile. Results: Out of the 1367 cases registered, 902 were anatomic lung resections. Patient's mean age was 59.6 years (±15.2) and 52.5% were women. The baseline diagnosis (n = 597) was lung cancer in 450 (75.3%), bronchiectasis or lung malformations in 70 (11.7%), tuberculosis-associated lung destruction in 57 (9.5%), and metastasis in 14 (2.4%). ASA score (n = 793) was 1 in 16.1%, 2 in 49.8%, 3 in 28.7%, and 4 in 5.4%. The resections performed were lobectomy in 681 cases (75.5%, 45% of which were VATS), pneumonectomy in 71 (7.9%, 13% VATS), bilobectomy 39 (4.3%, 13% VATS), and segmentectomy 111 (12.3%, 66% VATS). Morbidity rate was 36.7% and it varied according to the procedure performed. Complication profile was also different between lobectomy and pneumonectomy. Overall mortality rate was 2.6% (22/843) and it varied significantly according to the procedure performed, lobectomy 11/641 (1.7%), pneumonectomy 6/62 (8.8%), bilobectomy 2/36 (5.5%), and segmentectomy 3/104 (2.8%). Most relevant complications in patients with fatal outcome were pneumonia (11), myocardial infarct (3), bleeding requiring reoperation (1), and impossibility to wean from mechanical ventilation (1). Conclusion: Mortality and major morbidity rates of anatomic lung resections in Brazil are similar to other international series. Nevertheless, the high incidence of infectious complications as pneumonia and empyema is an issue to be studied and dealt with.