Associated Risks of Thoracic Surgery

Thoracic surgery is routinely performed all over the world. Australia benchmarks very well internationally, reflecting a high standard of care from both the operative setup and the hospital systems. As with any medical procedure, in a small number of cases, complications (adverse events) may occur. A large portion of the problems are consequences of previous conditions such as smoking, use of blood thinners, atherosclerosis, diabetes, previous diseases like stroke, heart, lung or renal failure, amongst others.

It is fair to say that there are risks associated with the procedure and to the individual patient. Hence, your specific circumstances should be discussed with your surgeon.

Common risks and complications of thoracic surgery (5% or more):

• Most patients will experience some pain or numbness around the chest incision.
• Air-leak from the lung – may require the chest tube to stay in longer.
• Feeling of restriction during breathing – this is due to the lung abutting the chest wall.
• Shortness of breath and need for oxygen – especially when a large part of lung has been removed or the lung is diffusely diseased (highly individual).
• Heart Problems – most commonly abnormal heart rhythm.
• Build up of fluid in the chest – may require re-insertion of a chest tube.

Uncommon risks and complications of thoracic surgery (1- 5%):

• Major bleeding and need for blood transfusion – caused by a torn blood vessel, or more commonly due to blood-thinning medications such as Aspirin, Clopidogrel, Warfarin, Rivaroxaban etc.
• Infection – at the wound or inside the chest, requiring antibiotics and drainage.
• Blood clots in the legs (Deep Venous Thrombosis or ‘DVT’) – cause pain and swelling of legs; rarely a clot breaks off and goes to the lungs. This requires blood thinners.
• Need for further surgery or bronchoscopy – to treat infection, bleeding, air-leak or to re-expand a collapsed lung.

Rare risks and complications of thoracic surgery (less than 1%):

• Nerve injury – due to proximity of the operative site and patient positioning during surgery: Phrenic nerve; Laryngeal nerve; Nerves to chest, arms and/or shoulder.
• Need for complete removal of the lung (pneumonectomy).
• Heart attack.
• Adult Respiratory Distress Syndrome. This can be a result of infection, trauma or shock.

The risk of death and respiratory failure varies according to the operation performed and patient’s specifics conditions/health status. Cardiac arrest, stroke and need for further major operations are rare. Cancer can recur independently of staging.

The risk of wound infection, chest infection, heart and lung complications and thrombosis increases with obesity and smoking.

Please talk to Dr Provenzano about your individual condition and circumstances, and about any questions or doubts you may have.