Coexisting diseases and postoperative morbidity in patients who underwent surgery due to pulmonary carcinoma and malignant carcinoma

Aim of the study: The aim of the study was to analyse the influence of coexisting diseases on postoperative morbidity in patients having undergone surgery for pulmonary carcinoma and malignant carcinoma.
Material and methods: A retrospective analysis was made of the medical histories of 100 consecutive patients operated on from January to August of 2006 in the Clinic of Thoracic Surgery and Cancer at the Oncology Centre in Bydgoszcz. The age of the patients ranged from 45 to 79 years (60.6 on average); 65 were men and 35 were women. 74 patients suffered from squamous cell pulmonary carcinoma when carcinomas were at stage I and II. Malignant cancer was detected in 26 patients after the primary lesion was cured.
Results: The risk of coexisting diseases was higher in patients over 60 years old. Heavy smoking for many years was a factor particularly related to the frequency of coexisting diseases. Coexisting diseases were detected in 77% of patients and the most frequent ones were: hypertension, cardiac infarction, diabetes, former known malignant disease with lung metastasis, chronic obstructive pulmonary disease and chronic gastric and/or duodenal ulcer. In 32 patients there were several coexisting diseases. The number of small and severe complications that existed in patients with hypertension, chronic obstructive pulmonary disease, gastric/duodenal ulcer and diabetes was similar to that in patients without complications. The number of small and severe complications was higher in patients after cardiac infarction; the differences were statistically significant. The type of surgery had a serious influence on postoperative complications. Complications were more frequent after a lung was removed. In multivariate analysis only cardiac infarction and smoking were found to have a significant influence on occurrence of postoperative complications. Diabetes and gastric/duodenal ulcer had a smaller effect on complications. Age, gender and motion skills according to Zubord as well as general health state according to ASA had no effect on early postoperative complications.
Conclusions: Coexisting diseases existed in 77% of patients who underwent surgery, after 60 years old mainly. History of myocardial infarction and history of smoking are significant factors associated with postoperative morbidity. Neoplastic disease has no effect on complications in patients who underwent surgery for metastasis.