Key Points

• Early postoperative complications are related to both operative technique and preoperative patient health.
• "The best treatment of postoperative complications is prevention." Careful patient selection, meticulous intraoperative technique, and attentive postoperative care are all essential to minimizing postoperative complications.
• Postoperative air leak remains a common complication that decreases quality of life and may prolong hospitalization.

Achieving an optimal outcome after pulmonary resection is a shared goal between surgeons and patients. While surgeons aim to avoid complications, the inherent physiologic stress and tissue manipulation of surgery may lead to postoperative pain and injury. Early postoperative complications are generally defined as those that occur during the index hospitalization and/or within two weeks of surgery. Complications in thoracic surgery are graded as either minor or major, depending on the invasiveness and quantity of management.[1]

Complications are related to both operative technique and preoperative patient health. As such, careful patient selection, meticulous intraoperative technique, and attentive postoperative care are all essential to minimizing postoperative complications. The use of minimally invasive surgical techniques, implementation of enhanced recovery protocols, and advances in postoperative monitoring and inpatient care, have all contributed to reducing postoperative complications.

This chapter provides a summary review of early postoperative complications that may occur after pulmonary resection, describing the incidence, risk factors, and management of some of the most common conditions. Importantly, the postoperative care of a patient who is to undergo pulmonary resection starts long before the incision is made. Smoking cessation, pulmonary rehabilitation, incentive spirometry teaching, and patient education are all critical factors that help minimize some of the more common early postoperative complications described in this chapter. Additionally, patients must be carefully selected for surgery by critically evaluating cardiopulmonary reserve, comorbidities and the patient’s sociomedical context for recovery.